Provider Demographics
NPI:1639817950
Name:GRAMM, JOSHUA
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:GRAMM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 PATTERSON RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15102-1501
Mailing Address - Country:US
Mailing Address - Phone:412-489-2803
Mailing Address - Fax:
Practice Address - Street 1:3600 SAW MILL RUN BLVD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:PA
Practice Address - Zip Code:15227-2710
Practice Address - Country:US
Practice Address - Phone:412-882-4140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029899225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist