Provider Demographics
NPI:1033723150
Name:PHEIL, GRANT (MS, LAT, ATC)
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:
Last Name:PHEIL
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 FRANKLIN PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37220-1196
Mailing Address - Country:US
Mailing Address - Phone:615-329-2520
Mailing Address - Fax:
Practice Address - Street 1:4700 FRANKLIN PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37220-1196
Practice Address - Country:US
Practice Address - Phone:615-329-2520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000051012OtherBOARD OF CERTIFICATION