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Individual

MR. GRANT LEE ROBINSON SR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
47 LAKEVIEW AVE, BRIDGETON, NJ 08302-1719
(856) 364-0544
(856) 300-5562
Mailing address
PO BOX 1511, MILLVILLE, NJ 08332-8511

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
374700000X
Technician
3747A0650X
Attendant Care Provider
Primary
3747P1801X
Personal Care Attendant
374U00000X
Home Health Aide

Other

Enumeration date
11/21/2017
Last updated
11/21/2017
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