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Individual
MR. GRANT PANZELLA
Active
Individual
MR. GRANT PANZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.026061
IL
2255A2300X
Athletic Trainer
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
Other
Enumeration date
09/15/2015
Last updated
11/01/2021
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