Individual
MARY LOU GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
HIS
Contact information
Practice address
1317 GLENWOOD DR, CLEBURNE, TX 76033-4654
(817) 641-3750
Mailing address
1317 GLENWOOD DR, CLEBURNE, TX 76033-4654
(817) 641-3750
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
80687
TX
Other
Enumeration date
04/28/2020
Last updated
04/28/2020
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