Individual
RICHARD GRANT II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
895 PORTLAND RD, SACO, ME 04072-9673
(207) 439-5104
Mailing address
895 PORTLAND RD, SACO, ME 04072-9673
(207) 439-5104
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PA4467
ME
Other
Enumeration date
08/10/2015
Last updated
08/10/2015
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