Individual
GINA GRANSTAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1420 W BADDOUR PKWY, LEBANON, TN 37087-1510
(615) 443-9036
(615) 443-9037
Mailing address
514 TIMS WAY DR, LEBANON, TN 37087-0220
(615) 449-5547
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA0000002723
TN
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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