Individual
MRS. CHRISTINE GRANNAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2353
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2353
PTA - LICENSE
SC
Enumeration date
10/01/2009
Last updated
10/01/2009
Update your record
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