Provider Demographics
NPI:1326198789
Name:GRANT, DAVID (CMT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:GRANT
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13115 E ELK PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-4428
Mailing Address - Country:US
Mailing Address - Phone:303-425-7298
Mailing Address - Fax:303-940-8330
Practice Address - Street 1:8725 WADSWORTH BLVD
Practice Address - Street 2:UNIT A
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80003-0928
Practice Address - Country:US
Practice Address - Phone:303-425-7298
Practice Address - Fax:303-940-8330
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist