Provider Demographics
NPI:1912209891
Name:RAINS, GRETA (PTA)
Entity Type:Individual
Prefix:
First Name:GRETA
Middle Name:
Last Name:RAINS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5901 BROKEN SOUND PKWY
Mailing Address - Street 2:STE 500
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-2773
Mailing Address - Country:US
Mailing Address - Phone:800-875-8999
Mailing Address - Fax:561-955-9881
Practice Address - Street 1:5901 BROKEN SOUND PKWY
Practice Address - Street 2:STE 500
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-2773
Practice Address - Country:US
Practice Address - Phone:800-875-8999
Practice Address - Fax:561-955-9881
Is Sole Proprietor?:No
Enumeration Date:2010-11-25
Last Update Date:2010-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-0435225200000X
CAAT-8979225200000X
WYPTA-0639225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant