Judy Grubb, LPTA

Individual provider Active NPI Physical Therapy Assistant · Brewster, OH

NPI 1013471077 · NPPES record last updated Jan 24, 2019

Key facts

NPI
1013471077
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
5316 (OH)
Practice address
264 Mohican St NE
Brewster, OH 44613-1199
Phone
(330) 767-4179
NPI assigned
Jan 24, 2019
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5316OHMDPsychologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 5316 OH Yes

Addresses

Primary practice location

264 Mohican St NE
Brewster, OH 44613-1199

Mailing address

15091 Orrville St NW
North Lawrence, OH 44666-9610
Phone (330) 904-4374

Other providers in Brewster, OH

All providers in Brewster, OH · Physical Therapy Assistant in Ohio

Sources for this page

Verify at the official NPI Registry.