Healthcare Provider Details

I. General information

NPI: 1821032319
Provider Name (Legal Business Name): GREGORY KRAUTNER PT DPT LSSBB
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 VERMONT AVE NW
WASHINGTON DC
20420-4745
US

IV. Provider business mailing address

15201 LAVENHAM TER
MIDLOTHIAN VA
23112-1903
US

V. Phone/Fax

Practice location:
  • Phone: 727-804-3981
  • Fax:
Mailing address:
  • Phone: 727-804-3981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number2305212726
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number2305212726
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: