Provider Demographics
NPI:1366718207
Name:GRIGSBY, JODY A (PT)
Entity type:Individual
Prefix:MRS
First Name:JODY
Middle Name:A
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13800 W 116TH ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66062-7808
Mailing Address - Country:US
Mailing Address - Phone:913-323-7129
Mailing Address - Fax:
Practice Address - Street 1:13800 METCALF AVENUE
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-1200
Practice Address - Country:US
Practice Address - Phone:913-685-5892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-26
Last Update Date:2019-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-01613225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist