-- TONY LANE GRANT --
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1558754481- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1351 W PINE AVE, MERIDIAN, ID, 836425031
- Phone
- (208) 888-7049
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: ID #3660