MR. Grant Allen Peacock III, PT

NPI #1942411699 in Tucker, Georgia

Provider Information

NPI Number: 1942411699
Entity Type: Individual
Name: MR. Grant Allen Peacock III, PT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: PT
Enumeration Date: May 24, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 2627 CHURCHWELL LN
City: Tucker
State: Georgia
ZIP Code: 30084-2412
Phone: (770) 491-8511

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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