Individual
AVERY GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
501 W BROADWAY, SAN DIEGO, CA 92101-3536
(619) 237-9027
Mailing address
801 A ST APT 1905, SAN DIEGO, CA 92101-4559
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
308248
CA
Other
Enumeration date
07/25/2025
Last updated
07/25/2025
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