Individual
GRANT FORREST CRERIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
8115 E INDIAN BEND RD, SCOTTSDALE, AZ 85250-4819
(480) 951-6451
Mailing address
914 S MELODY LN, TEMPE, AZ 85281-4430
(480) 593-4210
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9415A
AZ
Other
Enumeration date
08/12/2011
Last updated
08/12/2011
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