Individual
GRANT FRAGASSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
2 GREEN VALLEY DR, CHURCHVILLE, PA 18966-1613
(215) 962-0749
Mailing address
2 GREEN VALLEY DR, CHURCHVILLE, PA 18966-1613
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT006437
PA
Other
Enumeration date
02/15/2018
Last updated
02/15/2018
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