Healthcare Provider Details

I. General information

NPI: 1760006563
Provider Name (Legal Business Name): AUSTIN KRIER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 06/08/2020
Certification Date: 06/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3960 VALLEY GATEWAY BLVD STE A3
ROANOKE VA
24012-6859
US

IV. Provider business mailing address

4533 BRAMBLETON AVE
ROANOKE VA
24018-3436
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-8022
  • Fax:
Mailing address:
  • Phone: 540-772-8022
  • Fax: 540-772-0294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2305213633
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: