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Individual

DAVID GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT, COMT

Contact information

Practice address
11330 OLIVE BLVD STE 130, CREVE COEUR, MO 63141-7149
(314) 896-2205
Mailing address
647 SPIRIT AIRPARK WEST DR STE 101, CHESTERFIELD, MO 63005-1032
(636) 223-5700

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070-014285
LICENSE #
IL
Enumeration date
08/30/2006
Last updated
08/08/2024
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