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Individual

RUSSELL JOHN GRANT II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
821 S TREMONT ST STE A, OCEANSIDE, CA 92054-4158
(760) 542-6666
Mailing address
3554 VILLAGE COMMERCIAL DR APT 204, OCEANSIDE, CA 92056-2421

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
307133
CA
2251X0800X
Orthopedic Physical Therapist
Primary
307133
CA

Other

Enumeration date
11/07/2024
Last updated
12/30/2025
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