Individual
GRANT MICHAEL BURLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
214 18TH ST SE, HICKORY, NC 28602-1363
(828) 485-2160
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-3611
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16664
NC
Other
Enumeration date
04/02/2024
Last updated
12/16/2024
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