Provider Demographics
NPI:1407150329
Name:HOYT, GRANT ALLEN (PTA)
Entity Type:Individual
Prefix:MR
First Name:GRANT
Middle Name:ALLEN
Last Name:HOYT
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 HIGHLANDS DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-7837
Mailing Address - Country:US
Mailing Address - Phone:614-787-6936
Mailing Address - Fax:
Practice Address - Street 1:4801 HIGHLANDS DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-7837
Practice Address - Country:US
Practice Address - Phone:614-787-6936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2026968390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program