Individual
HEATHER KAY GRANZELLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1000 BALSAM ST, LAKEWOOD, CO 80214-4011
(719) 221-2414
Mailing address
1000 BALSAM ST, LAKEWOOD, CO 80214-4011
(719) 221-2414
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013126
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013126
MEDICARE
CO
Enumeration date
04/26/2013
Last updated
04/26/2013
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