Provider Demographics
NPI:1609208628
Name:GRIGG, KATE HELENA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:HELENA
Last Name:GRIGG
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:HELENA
Other - Last Name:BROUSSARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:530 SHADOWS LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6530
Mailing Address - Country:US
Mailing Address - Phone:225-927-9185
Mailing Address - Fax:225-231-3833
Practice Address - Street 1:530 SHADOWS LN
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6530
Practice Address - Country:US
Practice Address - Phone:225-927-9185
Practice Address - Fax:225-231-3833
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA08591225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist