Individual
ALYSSA LEE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4627
ME
Other
Enumeration date
09/05/2018
Last updated
02/10/2023
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