Individual
MARGO GRANT-BRYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19395 N JOHN WAYNE PKWY, MARICOPA, AZ 85139-2833
(951) 712-1097
Mailing address
20443 N SANTA CRUZ DR, MARICOPA, AZ 85138-5587
(951) 712-1097
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
KK283615
CA
Other
Enumeration date
08/24/2015
Last updated
08/24/2015
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