Provider Demographics
NPI:1841206943
Name:GREB, TRACY R (PT)
Entity Type:Individual
Prefix:
First Name:TRACY
Middle Name:R
Last Name:GREB
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 1:6209 OAK HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST FARMINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44491-8704
Mailing Address - Country:US
Mailing Address - Phone:330-883-5430
Mailing Address - Fax:
Practice Address - Street 1:53A E MAIN ST
Practice Address - Street 2:
Practice Address - City:ORWELL
Practice Address - State:OH
Practice Address - Zip Code:44076-9428
Practice Address - Country:US
Practice Address - Phone:440-437-5678
Practice Address - Fax:440-437-1047
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
OH006855225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist