Organization
CRYOWELL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DWIGHT ALEXANDER PEEPLES JR. (OWNER)
(404) 320-0981
Entity
Organization
Contact information
Practice address
37 BRENDAN WAY, GREENVILLE, SC 29615-3514
(687) 866-3646
(888) 651-5324
Mailing address
3842 MOURNING DOVE DR, WEDDINGTON, NC 28104-8636
(404) 308-0981
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8180
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH3404
—
SC
Enumeration date
09/25/2017
Last updated
09/25/2017
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