Individual
TYLOR PAUL GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
20045 N 19TH AVE BLDG 8, PHOENIX, AZ 85027-4267
(623) 594-9034
Mailing address
4545 W BEARDSLEY RD APT 1027, GLENDALE, AZ 85308-5012
(920) 296-0226
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
WI
2251X0800X
Orthopedic Physical Therapist
Primary
LPT-30965
AZ
Other
Enumeration date
06/07/2018
Last updated
01/06/2020
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