Individual provider · Type 1 NPI

Wiley Grantham Iv

Physical Therapy Assistant · Lake City, FL

NPI number 1619583689 Active

Practice location

560 SW Mcfarlane Ave
Lake City, FL 32025-5614

Call (386) 758-4777 Map

Mailing address

438 SE Lillian Loop Apt 103
Lake City, FL 32025-7248

Specialties and licenses

TaxonomyCodeLicense
Physical Therapy Assistant Primary 225200000X26541 (FL)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1619583689

Wiley Grantham Iv's National Provider Identifier is 1619583689, issued on Sep 16, 2020. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Lake City, FL. The record was last updated on Sep 16, 2020.