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NPI Code Detail

MEDICARE: GRANT T REED ATC, LAT

MEDICARE: GRANT T REED ATC, LAT
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1265295257
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRANT T REED ATC, LAT
Provider Business Mailing Address
First Line : 2805 CAMPUS DR STE 465
Second Line :
City : PLYMOUTH
State : MN
Zip : 55441-2680
Country : US
Telephone Number : 763-577-7400
Fax Number :
Provider Business Practice Location Address
First Line : 2805 CAMPUS DR STE 465
Second Line :
City : PLYMOUTH
State : MN
Zip : 55441-2680
Country : US
Telephone Number : 763-577-7400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2024
Last Update Date : 05/28/2026

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Directions to “ GRANT T REED ATC, LAT” Practice Location

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