Healthcare Provider Details

I. General information

NPI: 1316875792
Provider Name (Legal Business Name): RILEY CROGHAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4290 IVY RD STE 120
CHARLOTTESVILLE VA
22903-7010
US

IV. Provider business mailing address

4290 IVY RD STE 120
CHARLOTTESVILLE VA
22903-7010
US

V. Phone/Fax

Practice location:
  • Phone: 434-327-5244
  • Fax: 434-326-1353
Mailing address:
  • Phone: 434-327-5244
  • Fax: 434-326-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: