Individual
MISS VONDA GAIL GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, OTR
Contact information
Practice address
4701 N KEYSTONE AVE, INDIANAPOLIS, IN 46205-1554
(317) 722-8200
Mailing address
6001 TYBALT DR, INDIANAPOLIS, IN 46254-5163
(317) 388-8095
(317) 388-8095
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
31001025A
IN
Other
Enumeration date
06/13/2007
Last updated
04/12/2022
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