Provider Demographics
NPI:1669526869
Name:BARRY-GREB, THERESA (PT MS)
Entity type:Individual
Prefix:MRS
First Name:THERESA
Middle Name:
Last Name:BARRY-GREB
Suffix:
Gender:F
Credentials:PT MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 HIGHLAND PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-3546
Mailing Address - Country:US
Mailing Address - Phone:859-625-9700
Mailing Address - Fax:859-625-1555
Practice Address - Street 1:370 HIGHLAND PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-3546
Practice Address - Country:US
Practice Address - Phone:859-625-9700
Practice Address - Fax:859-625-1555
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001177225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist