Individual
ALEXANDRA KIRSTIN GRANT
Active
Individual
ALEXANDRA KIRSTIN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0288711
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000530185001
BLUE CROSS
NY
01
—
161608285
NOVA
NY
Enumeration date
05/29/2008
Last updated
05/29/2008
Update your record
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