Individual
MRS. CATHERINE CORISH GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
60 EXCHANGE STREET, SUITE B-7, RICHMOND HILL, GA 31324
(912) 756-2273
Mailing address
114 GREAT OAKS WAY, RICHMOND HILL, GA 31324-5461
(912) 596-8868
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004290
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0288PA
—
SC
05
—
328595480B
—
GA
Enumeration date
07/15/2005
Last updated
03/12/2009
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