Provider Demographics
NPI:1336297597
Name:GRONLUND, RAYMOND TODD (DPT)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:TODD
Last Name:GRONLUND
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 CRESSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:PA
Mailing Address - Zip Code:15037-2423
Mailing Address - Country:US
Mailing Address - Phone:412-751-2451
Mailing Address - Fax:
Practice Address - Street 1:116 CRESSWOOD DR
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:PA
Practice Address - Zip Code:15037-2423
Practice Address - Country:US
Practice Address - Phone:412-751-2451
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT004037E225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist