Provider Demographics
NPI:1023348927
Name:WINTZ, GREGORY (PHD, OTR/L)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:
Last Name:WINTZ
Suffix:
Gender:M
Credentials:PHD, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 N RIVERPOINT BLVD
Mailing Address - Street 2:BOX R
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1610
Mailing Address - Country:US
Mailing Address - Phone:509-368-6562
Mailing Address - Fax:509-368-6561
Practice Address - Street 1:310 N RIVERPOINT BLVD
Practice Address - Street 2:BOX R
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1610
Practice Address - Country:US
Practice Address - Phone:509-368-6562
Practice Address - Fax:509-368-6561
Is Sole Proprietor?:No
Enumeration Date:2009-12-28
Last Update Date:2009-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA27801225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist