National Provider Identifier

Grady T Slack, DPT

Grady T Slack, DPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Rochester, NY and a listed phone number of (585) 338-3070.

NPI 1194771345Rochester, NYPhysical Therapist

Profile Overview

NPI
1194771345
Provider Type
Individual
Primary Specialty
Physical Therapist
Enumeration Date
May 26, 2006
Last Updated
July 08, 2007

Practice Location

  • 1 Whipple Lane
  • Rochester, NY 14622

Phone: (585) 338-3070

Mailing Address

  • 480 Granger Circle
  • Webster, NY 14580

Specialties

  • Physical Therapist (225100000X)
Full Record
NPI
1194771345
Entity Type
Individual
Last Name
Slack
First Name
Grady
Middle Name
T
Name Prefix
Mr.
Credential
DPT
Mailing Street Address
480 Granger Circle
Mailing City
Webster
Mailing State
NY
Mailing ZIP Code
14580
Mailing Country
US
Mailing Phone
(585) 787-0057
Practice Street Address
1 Whipple Lane
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14622
Practice Country
US
Practice Phone
(585) 338-3070
Practice Fax
(585) 336-5014
Enumeration Date
May 26, 2006
Last Updated
July 08, 2007
Sex
Male
Sole Proprietor
X
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Physical Therapist (225100000X)