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Individual

JOSEPH D GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT ATC EDM

Contact information

Practice address
4740 MAIN ST, WAITSFIELD, VT 05673
(802) 496-4292
(802) 496-4262
Mailing address
4740 MAIN ST, WAITSFIELD, VT 05673
(802) 496-4292
(802) 496-4262

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040.0002677
VT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00019191
BCBS
VT
Enumeration date
03/22/2006
Last updated
10/11/2013
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