Provider Demographics
NPI:1568607331
Name:GRIESE, TRICIA ANNE (PT)
Entity Type:Individual
Prefix:MS
First Name:TRICIA
Middle Name:ANNE
Last Name:GRIESE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:TRICIA
Other - Middle Name:ANNE
Other - Last Name:GUERIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:KID START
Mailing Address - Street 2:5871 GROVELAND STATION RD
Mailing Address - City:MT. MORRIS
Mailing Address - State:NY
Mailing Address - Zip Code:14510
Mailing Address - Country:US
Mailing Address - Phone:585-658-4023
Mailing Address - Fax:585-658-4066
Practice Address - Street 1:KID START
Practice Address - Street 2:5871 GROVELAND STATION RD
Practice Address - City:MT. MORRIS
Practice Address - State:NY
Practice Address - Zip Code:14510
Practice Address - Country:US
Practice Address - Phone:585-658-4023
Practice Address - Fax:585-658-4066
Is Sole Proprietor?:No
Enumeration Date:2008-12-09
Last Update Date:2023-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014296-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist