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NPI Code Detail

MEDICARE: CORTNEY GRIGSBY OTR/L

MEDICARE: CORTNEY GRIGSBY OTR/L
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
1225XP0200XPediatric Occupational Therapist1730WV

General Provider Information

NPI Number : 1588072714
Entity Type Code : Individual
Provider Name (Legal Business Name) : CORTNEY GRIGSBY OTR/L
Provider Business Mailing Address
First Line : PO BOX 450
Second Line :
City : SCOTT DEPOT
State : WV
Zip : 25560-0450
Country : US
Telephone Number : 304-760-6300
Fax Number : 304-201-5123
Provider Business Practice Location Address
First Line : 179 STATION PL
Second Line : SUITE 100
City : HURRICANE
State : WV
Zip : 25526-6578
Country : US
Telephone Number : 304-760-6300
Fax Number : 304-201-5123
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2014
Last Update Date : 07/31/2014

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Directions to “ CORTNEY GRIGSBY OTR/L” Practice Location

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