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General NPI Number Information
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NPI Number | 1235899923
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Entity Type | Individual
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Provider Name | GRANT TRAEGER
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Gender | Male
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Dates
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Enumeration Date | 12/22/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 7060 HIGHLAND DR
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City | PITTSBURGH
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State | PA
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Zip | 15206-1259
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Country | US
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Telephone | 412-665-6706
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Fax |
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Provider Business Mailing Address
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Address Line | 8836 ROYAL MANOR DR APT 303
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City | ALLISON PARK
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State | PA
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Zip | 15101-2774
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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