Individual
GREGORY T. HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
00269
WV
225100000X
Physical Therapist
Primary
000269
WV
225100000X
Physical Therapist
2305001499
VA
2251X0800X
Orthopedic Physical Therapist
2305001499
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0156637000
—
WV
05
—
3810004945
—
VA
Enumeration date
11/01/2006
Last updated
07/21/2015
Update your record
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