Organization
THE GRANT CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE DIGGES (OFFICE MANAGER)
(602) 395-0718
Entity
Organization
Contact information
Practice address
525 N 18TH ST, 403, PHOENIX, AZ 85006-4102
(602) 254-4228
(602) 254-6380
Mailing address
PO BOX 39179, PHOENIX, AZ 85069-9179
(602) 395-0718
(602) 277-8146
Taxonomy
Speciality
Code
Description
License number
State
261QP3300X
Pain Clinic/Center
Primary
—
—
Other
Enumeration date
06/18/2009
Last updated
06/26/2009
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