Provider Demographics
NPI:1699599886
Name:GRINER, JOHN ALEXANDER
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:ALEXANDER
Last Name:GRINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6553 AMANDA WAY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-8339
Mailing Address - Country:US
Mailing Address - Phone:573-673-4492
Mailing Address - Fax:
Practice Address - Street 1:3228 CLARKSVILLE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37218-2812
Practice Address - Country:US
Practice Address - Phone:615-594-2830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-13
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty