Individual
MICHELLE LEE GRGUROVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
13361 PIEDMONT VISTA DR, HAYMARKET, VA 20169-2658
(516) 319-4017
Mailing address
13361 PIEDMONT VISTA DR, HAYMARKET, VA 20169-2658
(516) 319-4017
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306604028
VA
Other
Enumeration date
01/22/2020
Last updated
01/22/2020
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