Individual
ALEXANDER GRIVNOVICS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
535 GRADYVILLE RD, NEWTOWN SQUARE, PA 19073-2812
(610) 558-5053
Mailing address
1938 E MOYAMENSING AVE, PHILA, PA 19148-2527
(267) 847-4741
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI004419
PA
Other
Enumeration date
12/27/2018
Last updated
12/27/2018
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