Provider Demographics
NPI:1316594203
Name:GRIESS, DYLAN (OTR/L)
Entity Type:Individual
Prefix:
First Name:DYLAN
Middle Name:
Last Name:GRIESS
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 MARKET ST APT 342
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80205-2064
Mailing Address - Country:US
Mailing Address - Phone:515-979-7241
Mailing Address - Fax:
Practice Address - Street 1:6021 S LIVERPOOL ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80016-6209
Practice Address - Country:US
Practice Address - Phone:720-870-9007
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-24
Last Update Date:2019-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOT.0006085225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist