Individual
ANDRE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7101 W 12TH ST STE 201, LITTLE ROCK, AR 72204-2404
(501) 663-1837
Mailing address
1301 CUMBERLAND ST, LITTLE ROCK, AR 72202-5062
(843) 826-1894
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/12/2014
Last updated
06/12/2014
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