Provider Demographics
NPI:1295237303
Name:SLOVIN, GRANT (ATC)
Entity type:Individual
Prefix:MR
First Name:GRANT
Middle Name:
Last Name:SLOVIN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9457 LAWLER AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-1272
Mailing Address - Country:US
Mailing Address - Phone:224-436-7707
Mailing Address - Fax:
Practice Address - Street 1:BOWLING GREEN STATE UNIVERSITY
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:OH
Practice Address - Zip Code:43403-4607
Practice Address - Country:US
Practice Address - Phone:419-372-2531
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-05
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program