Individual
MR. EARL LAURENCE GRINE JR.
Active
Individual
MR. EARL LAURENCE GRINE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MSPT, ATC, CSCS
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305202763
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
172810
BLUE CROSS / BLUE SHIELD
VA
01
—
604546000
DEPARTMENT OF LABOR
DC
Enumeration date
10/23/2006
Last updated
07/21/2022
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