Individual
MICHELLE LEEANN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
100 NORTH ACADEMY AVE, DANVILLE, PA 17822-0131
(570) 271-6338
(570) 271-6105
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
OS017402
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/02/2010
Last updated
08/31/2020
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