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General NPI Number Information
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NPI Number | 1528289246
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Entity Type | Individual
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Provider Name | THOMAS GRELLO PT
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Gender | Male
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 20 N WOODBURY TURNERSVILLE RD
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City | BLACKWOOD
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State | NJ
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Zip | 08012-2888
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Country | US
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Telephone | 856-374-6665
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 FERRELL RD
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City | MONROEVILLE
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State | NJ
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Zip | 08343-2810
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Country | US
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Telephone | 856-478-4127
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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 | 40 QA00455000
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License Number State | NJ
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