Provider Demographics
NPI:1093836595
Name:ROOF, GRETA P (PT)
Entity Type:Individual
Prefix:MRS
First Name:GRETA
Middle Name:P
Last Name:ROOF
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 HIGH HOPES CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-1452
Mailing Address - Country:US
Mailing Address - Phone:615-661-5437
Mailing Address - Fax:
Practice Address - Street 1:301 HIGH HOPES CT
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-1452
Practice Address - Country:US
Practice Address - Phone:615-661-5437
Practice Address - Fax:615-277-2838
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2017-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN82082251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics