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General NPI Number Information
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NPI Number | 1639327513
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Entity Type | Individual
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Provider Name | ELIZABETH ASHLEY GRINER MPT
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Gender | Female
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 09/03/2008
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Provider Practice Location Address
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Address Line | 10420 KINGSTON PIKE STE H
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City | KNOXVILLE
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State | TN
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Zip | 37922-3261
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Country | US
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Telephone | 865-690-5494
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Fax |
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Provider Business Mailing Address
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Address Line | 1505 KATHY CIR
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City | KINGSTON
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State | TN
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Zip | 37763-3001
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Country | US
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Telephone | 865-717-8523
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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 | PT0000007821
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License Number State | TN
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