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General NPI Number Information
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NPI Number | 1023224862
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Entity Type | Individual
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Provider Name | SHERI LEIGH GROSSGLASS MPT
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 3904 BELLEWATER BLVD
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City | RIVERVIEW
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State | FL
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Zip | 33569-3106
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Country | US
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Telephone | 813-626-4266
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Fax |
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Provider Business Mailing Address
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Address Line | 47 CAMELOT RIDGE DR
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City | BRANDON
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State | FL
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Zip | 33511-8099
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Country | US
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Telephone | 813-626-4266
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT18434
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License Number State | FL
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