NPI Code Detail JSON Logo

1255530697 NPI number — ANTHONY BRIAN GRANGER P.T.

NPI Number: 1255530697
Health Care Provider/Practitioner: ANTHONY BRIAN GRANGER P.T.

Information about “1255530697” NPI (ANTHONY BRIAN GRANGER P.T.) exists in 1255530697 in HTML format HTML  |  1255530697 in plain Text format TXT  |  1255530697 in PDF (Portable Document Format) PDF  |  1255530697 in an XML format XML  formats.

NPI Number : 1255530697 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1255530697",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "GRANGER",
    "FirstName": "ANTHONY",
    "MiddleName": "BRIAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "P.T.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3400 CALLOWAY DR STE 603",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BAKERSFIELD",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "93312-2514",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-377-1700",
    "MailingAddressFaxNumber": "661-616-9199",
    "FirstLinePracticeLocationAddress": "7737 MEANY AVE STE B5",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BAKERSFIELD",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "93308-5267",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-377-1700",
    "PracticeLocationAddressFaxNumber": "661-616-9199",
    "EnumerationDate": "07/16/2007",
    "LastUpdateDate": "06/07/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2251P0200X",
          "TaxonomyName": "Pediatric Physical Therapist",
          "LicenseNumber": "4382",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "4382",
          "LicenseNumberStateCode": "AZ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.