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Organization
RICHARD L GRANT MD PC
Active
Organization
RICHARD L GRANT MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LOCKE GRANT MD (PRESIDENT)
(309) 692-5550
Entity
Organization
Contact information
Practice address
7309 N KNOXVILLE, PEORIA, IL 61614
(309) 692-5550
(309) 692-5553
Mailing address
709 TOWNES COURT, PEORIA, IL 61615-1381
(309) 692-5550
(309) 692-5553
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
Primary
—
IL
Other
Enumeration date
10/21/2006
Last updated
08/22/2020
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