| Doctor Name: | GRANT SHANKS |
| NPI Number: | 1467787341 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 12359 |
| Business Practice Address: | 262 Leroy George Dr Clyde, NC - 287217430 |
| Business Phone Number: | 8284567311 |
| Business Fax Number: | |
| Mailing Address: | 32 Bage Street, WAYNESVILLE |
| State: | NC |
| Postal Code: | 28786 |
| Phone Number: | 9312656060 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2009 |
| NPI Last Update Date: | 10/09/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 12359 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |