DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. GRANT PANZELLA, PT, DPT, ATC

Active

MR. GRANT PANZELLA, PT, DPT, ATC is a Physical Therapy Assistant healthcare provider located in CALEDONIA, Illinois. NPI 1306215835 is currently active in the NPPES registry. Verify at CMS.

Physical Therapy Assistant · CALEDONIA, IL

Registration Details

NPI Number
1306215835
Provider Type
Individual
Gender
Male
NPI Issued
Sep 15, 2015 (10.87300752572 yrs)
Last Updated
Nov 1, 2021
License
070.026061 (IL)

Practice Information

Address
11917 LERWICK RD
CALEDONIA, IL, 610119781
Browse IL providers · Browse ZIP 61011
Phone
8159146650
Primary Specialty
Physical Therapy Assistant
225100000X
Additional Specialty
Physical Therapy Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.