Provider Demographics
NPI:1154835460
Name:GRANDY, WHITNEY JULIA (DPT)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:JULIA
Last Name:GRANDY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 MEDICAL PARK DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-4053
Mailing Address - Country:US
Mailing Address - Phone:301-565-3301
Mailing Address - Fax:
Practice Address - Street 1:2101 MEDICAL PARK DR STE 110
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-4053
Practice Address - Country:US
Practice Address - Phone:301-681-5806
Practice Address - Fax:301-681-5806
Is Sole Proprietor?:No
Enumeration Date:2017-11-22
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26809208100000X, 225100000X
VA2305211614208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation