Provider Demographics
NPI:1639051212
Name:GRIDER, EMMA (PT, DPT)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:GRIDER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6139 BURGIN DR
Mailing Address - Street 2:
Mailing Address - City:WHITESTOWN
Mailing Address - State:IN
Mailing Address - Zip Code:46075-9216
Mailing Address - Country:US
Mailing Address - Phone:317-755-6544
Mailing Address - Fax:
Practice Address - Street 1:521 ADAMS AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:WA
Practice Address - Zip Code:98356-9323
Practice Address - Country:US
Practice Address - Phone:360-496-5112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist