Individual
GRANT R. SWANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
765 N KELLOGG ST, 3RD FLOOR, GALESBURG, IL 61401-2875
(309) 343-3434
(309) 343-3456
Mailing address
135 N WILLIAMSBURG DR, BLOOMINGTON, IL 61704-3528
(309) 661-8823
(309) 881-8801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-019510
IL
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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