Ethan Grant
Ethan Grant is an Athletic Trainer in Fairfax, Virginia. Practices as a sole proprietor. Registered with an NPI since 2018.
- In the registry since
- 2018
Practice location Address checks out
11960 Artery DrFairfax, VA 22030-6711
Phone: (703) 803-8912
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X |
|---|
Record details
| NPI number | 1275018806 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | September 29, 2018 |
| Last updated in NPPES | September 29, 2018 |
| Mailing address | 11960 Artery Dr, Fairfax, VA 22030-6711 |
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