Individual
ALLISYN GRANTHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6851 OAK HALL LN STE 102, COLUMBIA, MD 21045-5815
(443) 979-7123
Mailing address
11 EDMONDSON RIDGE RD, CATONSVILLE, MD 21228-1901
(410) 446-2922
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
29661
MD
Other
Enumeration date
09/29/2022
Last updated
09/21/2023
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