Individual
MR. HARLAND THOMAS GRANT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
1 CUMBERLAND PL STE 108, BANGOR, ME 04401-5087
(207) 990-9000
(207) 945-8645
Mailing address
1202 ESSEX ST, BANGOR, ME 04401-2608
(207) 973-0430
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT786
ME
Other
Enumeration date
05/24/2007
Last updated
07/08/2007
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