Organization
BRADLEY P GRANT MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY P GRANT MD (OWNER)
(321) 724-2188
Entity
Organization
Contact information
Practice address
1480 S WICKHAM RD, W MELBOURNE, FL 32904-2447
(321) 724-2188
(321) 724-2833
Mailing address
1480 S WICKHAM RD, W MELBOURNE, FL 32904-2447
(321) 724-2188
(321) 724-2833
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/06/2007
Last updated
06/26/2008
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