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NPI Code Detail

MEDICARE: MR. ZACHARY ROBERT GRANT OTR/L

MEDICARE: MR. ZACHARY ROBERT GRANT OTR/L
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
1225X00000XOccupational Therapist0119008160VA

General Provider Information

NPI Number : 1568018968
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ZACHARY ROBERT GRANT OTR/L
Provider Business Mailing Address
First Line : 2618 GROVE AVE APT 103
Second Line :
City : RICHMOND
State : VA
Zip : 23220-4354
Country : US
Telephone Number : 609-276-7046
Fax Number :
Provider Business Practice Location Address
First Line : 4201 SPRING VALLEY RD STE 600
Second Line :
City : DALLAS
State : TX
Zip : 75244-1209
Country : US
Telephone Number : 214-575-2999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2019
Last Update Date : 04/06/2026

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