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Individual

MRS. HEATHER J GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.ED, ATC, CSCS

Contact information

Practice address
1000 WYOMING AVE, SCRANTON, PA 18509-2910
(570) 941-7737
Mailing address
104 AMITY AVE, OLD FORGE, PA 18518-1019

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004051
PA

Other

Enumeration date
03/06/2007
Last updated
07/08/2007
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