Provider Demographics
NPI:1851741524
Name:GRIGSBY, JAMIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 INTERLOCKEN PKWY
Mailing Address - Street 2:SUITE A100
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-3497
Mailing Address - Country:US
Mailing Address - Phone:303-460-0329
Mailing Address - Fax:303-460-0387
Practice Address - Street 1:325 INTERLOCKEN PKWY
Practice Address - Street 2:SUITE A100
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80021-3497
Practice Address - Country:US
Practice Address - Phone:303-460-0329
Practice Address - Fax:303-460-0387
Is Sole Proprietor?:No
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0014079225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist