Grantham, Rebecca L

Grantham, Rebecca L is an individual health care provider with primary practice located at 789 Tennessee St Suite 101, Bolivar TN 38008-2441. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as her primary health care specialty. Grantham, Rebecca L can be contacted via phone (731) 658-2206.

Contact Information

Primary practice address
789 Tennessee St Suite 101 Bolivar TN 38008-2441
Phone: (731) 658-2206
Fax: (731) 659-2061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 2893 Tennessee

Profile Details

NPI number 1487806378
LBN Legal business name Grantham, Rebecca L
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 22nd, 2008
Last updated Oct 22nd, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487806378 NPPES
Tennessee MEDICAID 0446631

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