Provider Demographics
NPI:1396214003
Name:GRACZYK, BRIANNA ELIZABETH
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:ELIZABETH
Last Name:GRACZYK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 BIEBER MILL RD
Mailing Address - Street 2:
Mailing Address - City:OLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19547-8899
Mailing Address - Country:US
Mailing Address - Phone:610-223-1163
Mailing Address - Fax:
Practice Address - Street 1:233 BIEBER MILL RD
Practice Address - Street 2:
Practice Address - City:OLEY
Practice Address - State:PA
Practice Address - Zip Code:19547-8899
Practice Address - Country:US
Practice Address - Phone:610-223-1163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer