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Individual

DR. TERRY LEE GRINDSTAFF JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, ATC

Contact information

Practice address
2500 CALIFORNIA PLZ, BOYNE 154, OMAHA, NE 68178-0133
(402) 280-5674
Mailing address
2500 CALIFORNIA PLZ, BOYNE 154, OMAHA, NE 68178-0133
(402) 280-5674

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305204077
VA
225100000X
Physical Therapist
Primary
2904
NE
2255A2300X
Athletic Trainer
0126000725
VA
2255A2300X
Athletic Trainer
334
NE
2255A2300X
Athletic Trainer
555
TN

Other

Enumeration date
03/23/2006
Last updated
09/13/2011
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