Provider Demographics
NPI:1578030227
Name:GROW WITH GREENE, PT
Entity Type:Organization
Organization Name:GROW WITH GREENE, PT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:469-275-1399
Mailing Address - Street 1:2201 LONG PRAIRIE RD STE 107-273
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75022-4832
Mailing Address - Country:US
Mailing Address - Phone:469-275-1399
Mailing Address - Fax:
Practice Address - Street 1:2201 LONG PRAIRIE RD STE 107-273
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75022-4832
Practice Address - Country:US
Practice Address - Phone:469-275-1399
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy