Provider Demographics
NPI:1942413232
Name:GRANT, DENNIS LEROY (PT PHYSICAL THERAPIS)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:LEROY
Last Name:GRANT
Suffix:
Gender:M
Credentials:PT PHYSICAL THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2145 PIN OAK ESTATES
Mailing Address - Street 2:
Mailing Address - City:CHARLES CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50616
Mailing Address - Country:US
Mailing Address - Phone:641-228-2109
Mailing Address - Fax:641-257-4339
Practice Address - Street 1:800 S MAIN ST
Practice Address - Street 2:FLOYD COUNTY HOSPITAL
Practice Address - City:CHARLES CITY
Practice Address - State:IA
Practice Address - Zip Code:50616-3320
Practice Address - Country:US
Practice Address - Phone:641-228-6344
Practice Address - Fax:641-257-4339
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA117225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist