Provider Demographics
NPI:1679768402
Name:GRIECO, LINDA JEAN (PT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:JEAN
Last Name:GRIECO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21101 TOWNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-9628
Mailing Address - Country:US
Mailing Address - Phone:704-895-2285
Mailing Address - Fax:
Practice Address - Street 1:127 MURRAH DR
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-2342
Practice Address - Country:US
Practice Address - Phone:803-328-6518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19252251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics