Individual
LAURA GRANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3611 TRANSMITTER RD, PANAMA CITY, FL 32404-9799
(850) 747-9688
Mailing address
2101 W HIGHWAY 390 APT 922, LYNN HAVEN, FL 32444-6509
(850) 867-2094
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA29434
FL
Other
Enumeration date
06/09/2020
Last updated
06/09/2020
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