Individual
CORNELIA M GERDE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., PT
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
Update your record
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