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Mr. Grant Allen Peacock III, PT
Specialist in Tucker, Georgia
NPI 1942411699

Grant Allen Peacock III is a Specialist based in Tucker, GA. Grant Allen Peacock III practices in Tucker, GA and has the professional credentials of PT. The NPI Number for Grant Allen Peacock III is 1942411699 and holds a License No. PT001863 (Georgia).

The current practice location address for Grant Allen Peacock III is 2627 Churchwell Ln, Tucker, GA and can be reached out via phone at 770-491-8511 and via fax at 770-491-6914.

Location: 2627 Churchwell Ln, Tucker, GA, 30084-2412
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1942411699
Provider Name
Grant Allen Peacock III
Credential
PT
Provider Entity Type
Individual
Gender
Male
Address
2627 Churchwell Ln, Tucker, GA, 30084-2412
Phone Number
770-491-8511
Fax Number
770-491-6914
Provider Enumeration Date
05/24/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2627 Churchwell Ln
City
Tucker
State
Georgia
Zip
30084-2412
Phone Number
770-491-8511
Fax Number
770-491-6914
person
Provider Business Mailing Address Details
Address
2627 Churchwell Ln
City
Tucker
State
Georgia
Zip
30084-2412
Phone Number
770-491-8511
Fax Number
770-491-6914
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
PT001863 (Georgia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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