Basic Information
| Provider Information | |||||||||
| NPI: | 1285984955 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRIER | ||||||||
| FirstName: | PATRICIA | ||||||||
| MiddleName: | ANITA | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MS, PT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DAVENPORT | ||||||||
| OtherFirstName: | PATRICIA | ||||||||
| OtherMiddleName: | ANITA | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | MS, PT | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1594 S BIRCH HAVEN BEACH DR | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496518630 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2312951080 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1900 S LACHANCE RD | ||||||||
| Address2: | |||||||||
| City: | LAKE CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496518022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2317753081 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/11/2012 | ||||||||
| LastUpdateDate: | 06/26/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 55-01001973 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.