Individual
GRANT MACERI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
704 HIGHWAY 71 W STE D200, BASTROP, TX 78602-4144
(949) 370-1561
Mailing address
6809 MOORES FERRY DR, DEL VALLE, TX 78617-3746
(949) 370-1561
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT127206
TX
Other
Enumeration date
04/04/2024
Last updated
04/04/2024
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