Provider Demographics
NPI:1760909204
Name:GRASSI, MEGHAN RENE
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:RENE
Last Name:GRASSI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 E 380 S
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-5552
Mailing Address - Country:US
Mailing Address - Phone:775-722-5815
Mailing Address - Fax:
Practice Address - Street 1:819 E 380 S
Practice Address - Street 2:
Practice Address - City:AMERICAN FORK
Practice Address - State:UT
Practice Address - Zip Code:84003-5552
Practice Address - Country:US
Practice Address - Phone:775-722-5815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-25
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker