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General NPI Number Information
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NPI Number | 1497194179
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Entity Type | Organization
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Legal Business Name | GARY CRUMMETT & SONS
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Dates
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Enumeration Date | 06/17/2013
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Last Update Date | 06/17/2013
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Provider Practice Location Address
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Address Line | 3437 BLOSSOM DR
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City | MOUNT CRAWFORD
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State | VA
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Zip | 22841-2121
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Country | US
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Telephone | 540-434-1030
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Fax |
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Provider Business Mailing Address
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Address Line | 3437 BLOSSOM DR
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City | MOUNT CRAWFORD
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State | VA
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Zip | 22841-2121
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Country | US
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Telephone | 540-434-1030
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. GARY RAY CRUMMETT
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Credential | CLASS A CONTRACTOR
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Telephone | 540-434-1030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171WH0202X
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Taxonomy Name | Home Modifications Contractor
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License Number | 2705141949A
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License Number State | VA
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