Provider Demographics
NPI:1720222888
Name:TRACI LEIGH GREUEY
Entity Type:Organization
Organization Name:TRACI LEIGH GREUEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NON AGENCY PERSONAL CARE AIDE
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:GREUEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-962-5923
Mailing Address - Street 1:2965 N STATE ROUTE 377 NW
Mailing Address - Street 2:
Mailing Address - City:MALTA
Mailing Address - State:OH
Mailing Address - Zip Code:43758-9144
Mailing Address - Country:US
Mailing Address - Phone:740-962-5923
Mailing Address - Fax:
Practice Address - Street 1:2965 N STATE ROUTE 377 NW
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:OH
Practice Address - Zip Code:43758-9144
Practice Address - Country:US
Practice Address - Phone:740-962-5923
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health