Basic Information
| Provider Information | |||||||||
| NPI: | 1679768402 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GRIECO | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | JEAN | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21101 TOWNWOOD DR | ||||||||
| Address2: | |||||||||
| City: | CORNELIUS | ||||||||
| State: | NC | ||||||||
| PostalCode: | 280319628 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7048952285 | ||||||||
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| Practice Location | |||||||||
| Address1: | 127 MURRAH DR | ||||||||
| Address2: | |||||||||
| City: | ROCK HILL | ||||||||
| State: | SC | ||||||||
| PostalCode: | 297322342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8033286518 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/14/2007 | ||||||||
| LastUpdateDate: | 09/14/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2251G0304X | 1925 | NC | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics |
No ID Information.