Individual
CARRIE ANN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
423 SCRANTON CARBONDALE HWY, SCRANTON, PA 18508-1115
(570) 207-5502
(570) 207-5511
Mailing address
423 SCRANTON CARBONDALE HWY, S, SCRANTON, PA 18508-1115
(570) 207-5502
(570) 207-5511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
TPT020602
PA
2251P0200X
Pediatric Physical Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002056184
BS
PA
01
—
102261054
MEDICAL ASSISTANCE
PA
Enumeration date
05/29/2008
Last updated
11/03/2010
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