Individual
GRANT JEREMY COSGRIFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-S
Contact information
Practice address
304 SUMMIT ST, LEXINGTON, VA 24450-2424
(540) 460-5094
Mailing address
304 SUMMIT ST, LEXINGTON, VA 24450-2424
(540) 460-5094
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110007730
VA
Other
Enumeration date
05/04/2020
Last updated
08/17/2022
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