Individual
BRADEN GRANT LAWYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1227 LINCOLN AVE, EVANSVILLE, IN 47714-1043
(812) 259-5140
Mailing address
1227 LINCOLN AVE, EVANSVILLE, IN 47714-1043
(812) 259-5140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10004091A
IN
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
03/09/2022
Last updated
08/31/2023
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