NPI 1558754481

Tony Lane Grant

Practitioner Physical Therapy Assistant Meridian, ID

Practice location

Address: 1351 W Pine Ave, Meridian, ID 83642-5031
Phone: (208) 888-7049
Mailing address: 6155 W Villa Park St, Boise, ID 83703-6421

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence 3660 (ID)

Other Physical Therapy Assistant providers in Idaho →

Registry record

NPI: 1558754481
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Mar 2015
Record last updated: 17 Mar 2015

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.