Provider Demographics
NPI:1053327130
Name:GRINBLATAS, ERIN F (MSPT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:F
Last Name:GRINBLATAS
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-2335
Mailing Address - Country:US
Mailing Address - Phone:508-223-2300
Mailing Address - Fax:508-223-2340
Practice Address - Street 1:80 PARK ST
Practice Address - Street 2:
Practice Address - City:ATTLEBORO
Practice Address - State:MA
Practice Address - Zip Code:02703-2335
Practice Address - Country:US
Practice Address - Phone:508-223-2300
Practice Address - Fax:508-223-2340
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA16546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY69420Medicare ID - Type Unspecified