Individual
KELSEY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1419 MAIN STREET, TORRINGTON, WY 82240
(307) 532-4197
Mailing address
423 ALBANY AVE, TORRINGTON, WY 82240
(307) 359-4060
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC-1619
WY
Other
Enumeration date
10/13/2016
Last updated
02/16/2017
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