Grogg, Jamie Dyan

Grogg, Jamie Dyan is an individual health care provider with primary practice located at 4411 S Adams St , Marion IN 46953-5349. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Grogg, Jamie Dyan can be contacted via phone (765) 674-4455.

Contact Information

Primary practice address
4411 S Adams St Marion IN 46953-5349
Phone: (765) 674-4455
Fax: (765) 674-3577
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 05009584A Indiana

Profile Details

NPI number 1609037167
LBN Legal business name Grogg, Jamie Dyan
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 18th, 2008
Last updated Jun 18th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609037167 NPPES
Indiana Other 129137500 US DEPARTMENT OF LABOR
Indiana MEDICAID 100124000 US DEPARTMENT OF LABOR

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