Provider Demographics
NPI:1184694564
Name:GRELLO, LAWRENCE M (MSPT)
Entity type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:M
Last Name:GRELLO
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Gender:M
Credentials:MSPT
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Mailing Address - Street 1:211 SOUTH GULPH RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-4201
Mailing Address - Country:US
Mailing Address - Phone:610-265-2230
Mailing Address - Fax:610-265-2240
Practice Address - Street 1:211 SOUTH GULPH RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-4201
Practice Address - Country:US
Practice Address - Phone:610-265-2230
Practice Address - Fax:610-265-2240
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2013-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAPT013857L225100000X, 2251S0007X, 2251X0800X
PADAPT000658225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA084860Medicare PIN