Provider Demographics
NPI:1346898376
Name:MCGREAL, BRIDGET (LMT)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:
Last Name:MCGREAL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18768 ELM RD
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52076-8049
Mailing Address - Country:US
Mailing Address - Phone:563-245-3868
Mailing Address - Fax:
Practice Address - Street 1:413 HIGH ST NE
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9792
Practice Address - Country:US
Practice Address - Phone:563-929-1449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073067225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist