NPI 1033217054

Randall Walter Grossglass, PT

Practitioner Orthopedic Physical Therapist Brandon, FL

Practice location

Address: 134 E Bloomingdale Ave, Brandon, FL 33511-8101
Phone: (813) 681-1627
Fax: (813) 684-1356
Mailing address: 3904 Bellewater Blvd, Riverview, FL 33569-3106

Registered specialties

Orthopedic Physical Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2251X0800X Licence PT18479 (FL)

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Registry record

NPI: 1033217054
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Sep 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.