Individual
CARRIE GRISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4980 W SAHARA AVE STE 260, LAS VEGAS, NV 89146-3435
(702) 216-7365
Mailing address
10321 POMPEI PL, LAS VEGAS, NV 89144-1209
(952) 239-5250
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4505
NV
225100000X
Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4505
PT LICENSE
NV
01
—
7554
LICENSE #
MN
Enumeration date
08/30/2006
Last updated
11/08/2021
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