Individual
GRANT ANDERSON SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4353 KENTUCKY ST, GARY, IN 46409-2339
(219) 677-7668
Mailing address
4353 KENTUCKY ST, GARY, IN 46409-2339
(219) 677-7668
Taxonomy
Speciality
Code
Description
License number
State
343800000X
Secured Medical Transport (VAN)
Primary
0550-22-9431
IN
Other
Enumeration date
10/06/2014
Last updated
10/06/2014
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