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General NPI Number Information
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NPI Number | 1265435192
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Entity Type | Individual
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Provider Name | JOHN DAVID GRIGSBY MPT, CERT MDT
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Gender | Male
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 7730 WOLF RIVER BLVD SUITE 109
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City | GERMANTOWN
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State | TN
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Zip | 38138-1708
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Country | US
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Telephone | 901-522-6671
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Fax | 901-522-6715
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Provider Business Mailing Address
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Address Line | 7730 WOLF RIVER BLVD SUITE 109
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City | GERMANTOWN
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State | TN
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Zip | 38138-1708
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Country | US
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Telephone | 901-522-6671
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Fax | 901-522-6715
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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 | PT6639
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License Number State | TN
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