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Individual

CORNELIA M GERDE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.A., PT

Contact information

Practice address
8717 S HOSMER ST, STE A, TACOMA, WA 98444-1819
(253) 471-2727
(253) 471-2730
Mailing address
8717 S HOSMER ST, STE A, TACOMA, WA 98444-1819
(253) 471-2727
(253) 471-2730

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00000523
WA
2251P0200X
Pediatric Physical Therapist
PT00000523
WA

Other

Enumeration date
06/19/2012
Last updated
06/19/2012
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