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Individual

MS. SOREN LONG GRIEVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
3439 GLEN OAKS BLVD, SIOUX CITY, IA 51104-1761
(712) 277-8295
(712) 277-8206
Mailing address
3333 CONCORDIA DR, SIOUX CITY, IA 51104-2603
(712) 252-5123

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
02662
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0445361
IA
05
100251289-00
NE
01
23860
WELLMARK BCBS OF IA
IA
05
5835230
SD
Enumeration date
02/09/2007
Last updated
07/09/2007
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