# GRANT CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346558483
- **Authorized official:** MARC GRANT D.O. (PRESIDENT)
- **Authorized official phone:** (602) 327-0184

## Contact information

- **Practice address:** 708 S COEUR D ALENE LN, SUITE D, PAYSON, AZ 85541-5662
- **Practice address phone:** (928) 468-1337
- **Practice address fax:** (928) 468-1339
- **Mailing address:** 708 S COEUR DALENE LANE, SUITE D, PAYSON, AZ 85541-5662
- **Mailing address phone:** (928) 468-1337
- **Mailing address fax:** (928) 468-1339

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LA0401X | Addiction Medicine (Anesthesiology) Physician | 1609 | AZ | — |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 1609 | AZ | Yes |

## Other

- **Enumeration date:** 09/23/2010
- **Last updated:** 06/06/2013