Provider Demographics
NPI:1407554397
Name:GREGG, HANNAH TRICIA (DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:TRICIA
Last Name:GREGG
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 1:110105 PIONEER TRL W STE 201
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2680
Mailing Address - Country:US
Mailing Address - Phone:952-512-2470
Mailing Address - Fax:952-512-2479
Practice Address - Street 1:110105 PIONEER TRL W STE 201
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2680
Practice Address - Country:US
Practice Address - Phone:952-512-2470
Practice Address - Fax:952-512-2479
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12379225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist