Provider Demographics
NPI:1992019277
Name:GRUBBS, CAROLINE ASHLEY (DPT)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ASHLEY
Last Name:GRUBBS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ASHLEY
Other - Last Name:LAWLESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-954-7408
Practice Address - Street 1:3630 PEACHTREE PKWY
Practice Address - Street 2:SUITE 310
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6049
Practice Address - Country:US
Practice Address - Phone:678-473-1081
Practice Address - Fax:678-473-1082
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT10031225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist