Provider Demographics
NPI:1942963533
Name:GREZIAK, ANDRZEJ MAREK (PT)
Entity Type:Individual
Prefix:MR
First Name:ANDRZEJ
Middle Name:MAREK
Last Name:GREZIAK
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 HILLCREST CIR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-3807
Mailing Address - Country:US
Mailing Address - Phone:731-363-6283
Mailing Address - Fax:
Practice Address - Street 1:239 HOSPITAL CIR
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4550
Practice Address - Country:US
Practice Address - Phone:731-642-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty