Individual
CRAIG R. MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC
Contact information
Practice address
15757 WC MAIN ST, MIDLOTHIAN, VA 23113-7327
(804) 858-0220
(804) 419-0127
Mailing address
PO BOX 69030, BALTIMORE, MD 21264-9030
(757) 873-2302
(757) 873-2306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305210405
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689127508
MEDICAID QMB PROVIDER ID
VA
01
—
C05954
GROUP MEDICARE PTAN
VA
Enumeration date
07/27/2016
Last updated
04/25/2018
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