MEDICARE: CORALEE GREER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PTA000339	GA

General Provider Information

NPI Number	:	1497270185
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CORALEE GREER

Provider Business Mailing Address
First Line	:	100 CABANA CAY CIR UNIT 427
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-4666
Country	:	US
Telephone Number	:	850-691-7513
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 CABANA CAY CIR UNIT 427
Second Line	:
City	:	PANAMA CITY BEACH
State	:	FL
Zip	:	32413-4666
Country	:	US
Telephone Number	:	850-691-7513
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2017
Last Update Date	:	08/03/2017

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Directions to “ CORALEE GREER ” Practice Location

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