Individual
JENNIFER GRANADO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
804 LIVE OAK DR, ATLANTA, TX 75551-2817
(903) 826-5966
Mailing address
804 LIVE OAK DR, ATLANTA, TX 75551-2817
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
215790
TX
Other
Enumeration date
08/26/2018
Last updated
08/26/2018
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