Provider Demographics
NPI:1609135441
Name:GREWAL, HARPREET K (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HARPREET
Middle Name:K
Last Name:GREWAL
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 LEEWARD DR
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3416
Mailing Address - Country:US
Mailing Address - Phone:517-974-3661
Mailing Address - Fax:
Practice Address - Street 1:1240 MIZZEN DR
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3480
Practice Address - Country:US
Practice Address - Phone:517-974-3661
Practice Address - Fax:517-292-2432
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015174225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist