Individual
JEREMY GRYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
3787 WOODRIDGE BLVD., FAIRFIELD, OH 45014
(513) 874-1999
(513) 874-1653
Mailing address
7850 STONEGATE DRIVE, CINCINNATI, OH 45255
(513) 474-4486
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 010004
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0214940
—
OH
Enumeration date
11/01/2006
Last updated
07/08/2007
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