Provider Demographics
NPI:1407306392
Name:GRENIER, KELLEE ANN (DPT)
Entity Type:Individual
Prefix:
First Name:KELLEE
Middle Name:ANN
Last Name:GRENIER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3801 LAKE OTIS PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-5234
Mailing Address - Country:US
Mailing Address - Phone:907-562-2277
Mailing Address - Fax:907-563-3460
Practice Address - Street 1:1410 OAK ST. STE 100
Practice Address - Street 2:54 OAKWAY CENTER
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5645
Practice Address - Country:US
Practice Address - Phone:541-687-7005
Practice Address - Fax:541-687-7006
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61923225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist