Provider Demographics
NPI:1689430084
Name:GRIGSBY, LINDSY
Entity type:Individual
Prefix:
First Name:LINDSY
Middle Name:
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDSY
Other - Middle Name:
Other - Last Name:GRIGSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5407 NEW COPELAND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-3997
Mailing Address - Country:US
Mailing Address - Phone:678-837-7176
Mailing Address - Fax:404-777-1311
Practice Address - Street 1:5407 NEW COPELAND RD STE 100
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-3997
Practice Address - Country:US
Practice Address - Phone:903-630-7204
Practice Address - Fax:903-630-7205
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1389487225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist