Individual
MARCUS GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1380 S DELEON AVE, TITUSVILLE, FL 32780-7749
(321) 222-0172
(888) 859-2513
Mailing address
PO BOX 674, OCOEE, FL 34761-0674
(321) 222-0172
(888) 859-2513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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