MR. Grant Panzella, PT, DPT, ATC

NPI #1306215835 in Caledonia, Illinois

Provider Information

NPI Number: 1306215835
Entity Type: Individual
Name: MR. Grant Panzella, PT, DPT, ATC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT, ATC
Enumeration Date: Sep 15, 2015
Last Updated: Nov 1, 2021

Practice Location

Address: 11917 LERWICK RD
City: Caledonia
State: Illinois
ZIP Code: 61011-9781
Phone: (815) 914-6650

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X
Physical Therapist	225100000X	Primary

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