Individual
TONYA S CROCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4099 DAUGHERTY RD, SALEM, VA 24153-1993
(540) 380-2331
Mailing address
4099 DAUGHERTY RD, SALEM, VA 24153-1993
(540) 380-2331
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602794
VA
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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