GRANT MANGAN
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1841167483- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 500 CHESTERFIELD CTR STE 300, CHESTERFIELD, MO, 630174823
- Phone
- (636) 778-9643
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: MO #2025045402
All Addresses
MAILING
578 HIGHLAND RIDGE DR
BALLWIN, MO, 630112703