Provider Demographics
NPI:1922271246
Name:GRANT, TOREN (PT)
Entity Type:Individual
Prefix:
First Name:TOREN
Middle Name:
Last Name:GRANT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 BUCHANAN ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-6717
Mailing Address - Country:US
Mailing Address - Phone:336-682-0844
Mailing Address - Fax:
Practice Address - Street 1:7505 GREENWAY CENTER DR
Practice Address - Street 2:STE 301
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3507
Practice Address - Country:US
Practice Address - Phone:301-474-6505
Practice Address - Fax:301-474-2206
Is Sole Proprietor?:No
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22514225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist