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Individual

GREGORY LAYNE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
610 DAMES ST, SAINT ALBANS, WV 25177-2652
(304) 201-3150
(304) 201-3159
Mailing address
136 9TH AVE, HUNTINGTON, WV 25701-2708
(304) 539-6214
(304) 201-3159

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
WV 871
WV

Other

Enumeration date
04/17/2007
Last updated
07/08/2007
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