Basic Information
| Provider Information | |||||||||
| NPI: | 1891345336 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ROBBINS | ||||||||
| FirstName: | GRANT | ||||||||
| MiddleName: | ANTHONY | ||||||||
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| Credential: | PTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1690 E FIR AVE APT 240 | ||||||||
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| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937202788 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163424370 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7265 N 1ST ST STE 105 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937202956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5594318181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/17/2019 | ||||||||
| LastUpdateDate: | 09/17/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225200000X | PTA48809 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant |
No ID Information.