Healthcare Provider Details

I. General information

NPI: 1851335459
Provider Name (Legal Business Name): CROSSWAY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2006
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9129 MONROE RD SUITE 100-015
CHARLOTTE NC
28270-2429
US

IV. Provider business mailing address

9129 MONROE RD SUITE 100-105
CHARLOTTE NC
28270-2429
US

V. Phone/Fax

Practice location:
  • Phone: 704-847-3911
  • Fax: 704-847-2033
Mailing address:
  • Phone: 704-847-3911
  • Fax: 704-442-8724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHELLEY ANNE DEAN
Title or Position: OWNER, OCCUPATIONAL THERAPIST
Credential: OTD,OTR/L
Phone: 704-607-0014