Provider Demographics
NPI:1740431741
Name:GRIGSBY, TONNA LEE (PTA)
Entity type:Individual
Prefix:MRS
First Name:TONNA
Middle Name:LEE
Last Name:GRIGSBY
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 1:5506 E NEW MARGARET DR
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-9225
Mailing Address - Country:US
Mailing Address - Phone:812-645-2329
Mailing Address - Fax:812-645-2330
Practice Address - Street 1:5506 E NEW MARGARET DR
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803-9225
Practice Address - Country:US
Practice Address - Phone:812-645-2329
Practice Address - Fax:812-645-2330
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06003432A225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant