MEDICARE: KELLY GRANT PT, ATC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	PT007557	GA
2	2255A2300X	Athletic Trainer	AT000525	GA

General Provider Information

NPI Number	:	1871619072
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY GRANT PT, ATC

Provider Business Mailing Address
First Line	:	2988 EATON RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-2516
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2988 EATON RD
Second Line	:
City	:	SHAKER HEIGHTS
State	:	OH
Zip	:	44122-2516
Country	:	US
Telephone Number	:	216-991-1050
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1437272788 — KURT JENSEN PSY.D.
Practice Location Address:

2966 EATON RD
SHAKER HEIGHTS, OH
44122-2516

Practice Phone: 216-751-0710
Practice Fax:

1508199399 — WORKSMART CONSULTANTS, LLC
Practice Location Address:

2966 EATON RD
SHAKER HEIGHTS, OH
44122-2516

Practice Phone: 216-751-0710
Practice Fax: 888-882-3680

1407215528 — BENJAMIN A WHITE PT, DPT
Practice Location Address:

2516 FAIRWOOD CT
BEACHWOOD, OH
44122-1765

Practice Phone: 812-361-6212
Practice Fax:

1912405606 — BEN WHITE PHYSIOTHERAPY
Practice Location Address:

2516 FAIRWOOD CT
BEACHWOOD, OH
44122-1765

Practice Phone: 812-361-6212
Practice Fax:

1083834469 — MRS. DARLENE MARIE FLUELLEN
Practice Location Address:

2119 ROSSMOOR RD
CLEVELAND HEIGHTS, OH
44118-2516

Practice Phone: 216-321-1337
Practice Fax: 216-321-1337

1215368576 — TWIN DRAGON CONSULTING SERVICE,INC
Practice Location Address:

28 STIRRUP LN
ROSLYN HEIGHTS, NY
11577-2516

Practice Phone: 917-257-4086
Practice Fax:

Directions to “ KELLY GRANT PT, ATC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.