Healthcare Provider Details

I. General information

NPI: 1154720282
Provider Name (Legal Business Name): TIMOTHY J GREINER DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 WILLOW STREET PIKE N
WILLOW STREET PA
17584-9499
US

IV. Provider business mailing address

2929 WILLOW STREET PIKE N
WILLOW STREET PA
17584-9499
US

V. Phone/Fax

Practice location:
  • Phone: 717-584-4614
  • Fax: 484-470-1418
Mailing address:
  • Phone: 717-584-4614
  • Fax: 484-470-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number023922
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: