Individual
GRANT SHEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5255 E MARYLAND ST, DECATUR, IL 62521-9705
(217) 864-1264
Mailing address
5255 E MARYLAND ST, DECATUR, IL 62521-9705
(217) 972-8933
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160009029
IL
Other
Enumeration date
01/19/2026
Last updated
01/19/2026
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