Individual
JEFFREY B GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1649 LUCERNE ST, STE A & B, MINDEN, NV 89423-4363
(775) 782-1603
(775) 782-1629
Mailing address
1111 EMERALD BAY RD, SOUTH LAKE TAHOE, CA 96150-6207
(530) 543-5652
(530) 541-8723
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
951
NV
Other
Enumeration date
03/24/2006
Last updated
07/08/2007
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