Provider Demographics
NPI:1992029649
Name:GRUBB, MARY JANAE (DPT)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:JANAE
Last Name:GRUBB
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:JANAE
Other - Last Name:DEATS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:906 MEBANE OAKS RD
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-7951
Mailing Address - Country:US
Mailing Address - Phone:195-631-8259
Mailing Address - Fax:919-563-1833
Practice Address - Street 1:1225 HUFFMAN MILL RD STE 201
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-8789
Practice Address - Country:US
Practice Address - Phone:336-584-7689
Practice Address - Fax:336-584-8063
Is Sole Proprietor?:No
Enumeration Date:2010-03-24
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT020999225100000X
NCP12533225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist