Individual
BRANDI GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1202 S 21ST ST, NEW CASTLE, IN 47362-2523
(765) 465-2332
Mailing address
1202 S 21ST ST, NEW CASTLE, IN 47362-2523
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004464A
IN
225200000X
Physical Therapy Assistant
09159
OR
225200000X
Physical Therapy Assistant
A03380
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A03380
PTA LICENSE
KY
Enumeration date
09/28/2015
Last updated
09/28/2015
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