Individual
JONATHAN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5995
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-5995
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E1547812
TX
Other
Enumeration date
09/29/2014
Last updated
09/29/2014
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