MEDICARE: CHRISTOPHER GREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	0020095	CO

General Provider Information

NPI Number	:	1386477818
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GREN

Provider Business Mailing Address
First Line	:	3055 EAGLE WING WAY
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80109-3939
Country	:	US
Telephone Number	:	702-292-2492
Fax Number	:

Provider Business Practice Location Address
First Line	:	4714 MILESTONE LN STE B
Second Line	:
City	:	CASTLE ROCK
State	:	CO
Zip	:	80104-7908
Country	:	US
Telephone Number	:	303-660-5349
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2024
Last Update Date	:	08/21/2024

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Directions to “ CHRISTOPHER GREN ” Practice Location

Language	Start Address	Practice Location

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