Provider Demographics
NPI:1518990746
Name:GRIGG, AMI (MPT)
Entity Type:Individual
Prefix:MS
First Name:AMI
Middle Name:
Last Name:GRIGG
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 PARC RIVERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BELLE CHASSE
Mailing Address - State:LA
Mailing Address - Zip Code:70037-3014
Mailing Address - Country:US
Mailing Address - Phone:504-525-2225
Mailing Address - Fax:504-525-2259
Practice Address - Street 1:747 MAGAZINE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-3629
Practice Address - Country:US
Practice Address - Phone:504-525-2225
Practice Address - Fax:504-525-2259
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05000225100000X, 2251G0304X, 2251S0007X, 2251X0800X
GAPT009012225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4H490CQ30Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID#