Provider Demographics
NPI:1316346034
Name:GRIEBEL, CRAIG ANDREW (DPT)
Entity type:Individual
Prefix:
First Name:CRAIG
Middle Name:ANDREW
Last Name:GRIEBEL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 OLD SPRINGTOWN RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-2773
Mailing Address - Country:US
Mailing Address - Phone:817-220-6677
Mailing Address - Fax:817-220-6617
Practice Address - Street 1:407 OLD SPRINGTOWN RD
Practice Address - Street 2:SUITE 114
Practice Address - City:SPRINGTOWN
Practice Address - State:TX
Practice Address - Zip Code:76082-2773
Practice Address - Country:US
Practice Address - Phone:817-220-6677
Practice Address - Fax:817-220-6617
Is Sole Proprietor?:No
Enumeration Date:2014-08-19
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1247859225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist