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Individual
ETHAN GRANT
Active
Individual
ETHAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
PT016847
OH
390200000X
Student in an Organized Health Care Education/Training Program
Primary
57.259284
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/06/2019
Last updated
08/06/2025
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