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NPI Code Detail

MEDICARE: MRS. GRETCHEN TSOURIS MPT

MEDICARE: MRS. GRETCHEN TSOURIS MPT
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
1225100000XPhysical Therapist10426NC

General Provider Information

NPI Number : 1396931531
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GRETCHEN TSOURIS MPT
Provider Business Mailing Address
First Line : 523 SPRING HAVEN DR
Second Line :
City : RANDLEMAN
State : NC
Zip : 27317-8285
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6100 W FRIENDLY AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27410-4160
Country : US
Telephone Number : 336-292-1301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2007
Last Update Date : 09/21/2007

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Directions to “ MRS. GRETCHEN TSOURIS MPT” Practice Location

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