Provider Demographics
NPI:1992515597
Name:MULLINS, GRANT (DPT)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:
Last Name:MULLINS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1114 KENNESAW BLVD
Mailing Address - Street 2:
Mailing Address - City:GALLATIN
Mailing Address - State:TN
Mailing Address - Zip Code:37066-6062
Mailing Address - Country:US
Mailing Address - Phone:256-924-1514
Mailing Address - Fax:
Practice Address - Street 1:3100 VILLAGE PLAINS BLVD STE 160
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-5066
Practice Address - Country:US
Practice Address - Phone:629-239-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist