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NPI Code Detail

MEDICARE: MISS LAUREN REDDY GRAPPONE PTA

MEDICARE: MISS LAUREN REDDY GRAPPONE PTA
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
1225200000XPhysical Therapy Assistant3312NC

General Provider Information

NPI Number : 1538460829
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LAUREN REDDY GRAPPONE PTA
Provider Business Mailing Address
First Line : 79393 RIDGEHAVEN RD
Second Line :
City : LANCASTER
State : SC
Zip : 29720-6430
Country : US
Telephone Number : 980-833-0266
Fax Number :
Provider Business Practice Location Address
First Line : 6000 PARK SOUTH DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28210-3298
Country : US
Telephone Number : 704-551-6800
Fax Number : 704-551-6868
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2010
Last Update Date : 01/13/2023

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Directions to “ MISS LAUREN REDDY GRAPPONE PTA” Practice Location

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