Provider Demographics
NPI:1023786167
Name:CROSSLAND, PIPER LAUREL (DPT)
Entity type:Individual
Prefix:
First Name:PIPER
Middle Name:LAUREL
Last Name:CROSSLAND
Suffix:
Gender:
Credentials:DPT
Other - Prefix:
Other - First Name:PIPER
Other - Middle Name:LAUREL
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1684 POCAHONTAS ST
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23511-2921
Mailing Address - Country:US
Mailing Address - Phone:580-916-5349
Mailing Address - Fax:
Practice Address - Street 1:2121 S YUKON PKWY STE 200
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-7482
Practice Address - Country:US
Practice Address - Phone:405-578-5447
Practice Address - Fax:866-490-4693
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30366225100000X
VA2305215427225100000X
OK4949225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist