Individual
MR. GREG B CORNFORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
395 HIGHLAND DR., LEBANON, VA 24266
(276) 889-4090
(276) 889-4026
Mailing address
362 SUNSET DR, ABINGDON, VA 24210-2314
(276) 623-2128
(276) 889-4026
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305005530
VA
2251S0007X
Sports Physical Therapist
Primary
2305005530
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4979711
—
VA
Enumeration date
03/05/2007
Last updated
09/11/2025
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