Individual
DR. DAMON JOHN GRANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
3117 STILLWATER DR, PRESCOTT, AZ 86305-7164
(928) 442-0005
Mailing address
7159 S 233RD AVE, BUCKEYE, AZ 85326-8736
(417) 298-2372
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2009024412
MO
225100000X
Physical Therapist
3588
HI
225100000X
Physical Therapist
4147
NM
225100000X
Physical Therapist
Primary
9200
AZ
225100000X
Physical Therapist
PT-1455
WY
225100000X
Physical Therapist
PT-3025
ID
225100000X
Physical Therapist
PTH6368
AL
Other
Enumeration date
03/19/2013
Last updated
03/19/2013
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