Individual
JENNIFER GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
29 EAST MAIN STREET, GOUVERNEUR, NY 13642
(315) 287-5002
(180) 089-8423
Mailing address
147 CHURCH STREET, HERMON, NY 13652
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
20 046773
NY
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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