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General NPI Number Information
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NPI Number | 1629149109
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Entity Type | Individual
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Provider Name | MR. GRANT MCLEOD
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1355 37TH ST SUITE 401
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City | VERO BEACH
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State | FL
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Zip | 32960-7321
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Country | US
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Telephone | 772-569-7217
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Fax |
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Provider Business Mailing Address
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Address Line | 575 SARINA TER SW
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City | VERO BEACH
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State | FL
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Zip | 32968-4042
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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 | PT0016300
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License Number State | FL
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