Provider Demographics
NPI:1942021142
Name:GOLDSWORTH, CASSIDY ANN (PTA)
Entity type:Individual
Prefix:MRS
First Name:CASSIDY
Middle Name:ANN
Last Name:GOLDSWORTH
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 MEYERS WAY
Mailing Address - Street 2:
Mailing Address - City:CROZET
Mailing Address - State:VA
Mailing Address - Zip Code:22932-1598
Mailing Address - Country:US
Mailing Address - Phone:720-299-5855
Mailing Address - Fax:
Practice Address - Street 1:250 MERCHANT WALK AVE STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-6520
Practice Address - Country:US
Practice Address - Phone:434-328-4900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA23066006652225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant