WILEY GRANTHAM

LAKE CITY, FL
NPI1619583689
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: FL  26541)
Enumeration Date2020-09-16
Last Update Date2020-09-16
Business Address
Mr. WILEY GRANTHAM
560 SW MCFARLANE AVE
LAKE CITY, FL 32025-5614
Phone number: 386-758-4777
Mailing Address
Mr. WILEY GRANTHAM
438 SE LILLIAN LOOP APT 103
LAKE CITY, FL 32025-7248
Phone number: 386-965-7461
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