Individual
RAUSTIN JOSEF GRANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1951 BLUEGRASS CIR, CHEYENNE, WY 82009-7355
(307) 773-8533
(307) 635-7578
Mailing address
1951 BLUEGRASS CIR, CHEYENNE, WY 82009-7355
(307) 773-8533
(307) 635-7578
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-2227
WY
Other
Enumeration date
01/10/2023
Last updated
01/06/2025
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