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Contact Information

GRAND RIVER PHYSICAL THERAPY & SPORTS MEDICINE, INC
203 S POLK ST
ALBANY, MO64402-1618
 Phone: 660-726-5762
 Fax: 660-726-5764
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
 

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
 

Sports

2251S0007X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for GRAND RIVER PHYSICAL THERAPY & SPORTS MEDICINE, INC

NPI # 1841231214
LBN Legal business name GRAND RIVER PHYSICAL THERAPY & SPORTS MEDICINE, INC
Authorized official CHARLES GREENE - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 06/09/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
MO License # 104902
MO License # 106862
MO Other 35391014 BC/BS GROUP BILLING NUMBE
MO Other 10001794500 COMMUNITY HL PLAN PROV #
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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