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General NPI Number Information
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NPI Number | 1639983257
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Entity Type | Individual
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Provider Name | MICHAEL TAYLOR GRIEP
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Gender | Male
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 01/12/2026
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Provider Practice Location Address
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Address Line | 1050 ZEPHYR DR
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City | NEENAH
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State | WI
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Zip | 54956-1389
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Country | US
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Telephone | 847-226-1260
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N MAIN ST UNIT 504
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City | OSHKOSH
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State | WI
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Zip | 54901-5266
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Country | US
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Telephone | 847-226-1260
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | WI
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