Provider Demographics
NPI:1508070780
Name:GRIES, PATRICIA JOEL (PT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JOEL
Last Name:GRIES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:JOEL
Other - Last Name:CONDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:7591 TYLERS PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6308
Mailing Address - Country:US
Mailing Address - Phone:513-755-6600
Mailing Address - Fax:513-755-3762
Practice Address - Street 1:7591 TYLERS PLACE BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069
Practice Address - Country:US
Practice Address - Phone:513-755-6600
Practice Address - Fax:513-755-3762
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT-005697225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHAB7360731OtherMEDICARE PIN
OH0406425Medicaid
OHP00459886OtherMEDICARE RAILROAD
OH2764567Medicaid
OH2764567Medicaid