Provider Demographics
NPI:1750999850
Name:GREENBERG, JAMIE ELIZABETH (DPT)
Entity type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:ELIZABETH
Last Name:GREENBERG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 OLD SPRINGTOWN RD STE 114
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-2772
Mailing Address - Country:US
Mailing Address - Phone:817-220-6677
Mailing Address - Fax:
Practice Address - Street 1:407 OLD SPRINGTOWN RD STE 114
Practice Address - Street 2:
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-2772
Practice Address - Country:US
Practice Address - Phone:817-220-6677
Practice Address - Fax:817-220-6617
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist