Individual
CANDACE REYNOLDS GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-5105
(334) 671-5073
Mailing address
1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL 36302-3030
(334) 793-5105
(334) 671-5073
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1102842
AL
Other
Enumeration date
02/09/2010
Last updated
10/22/2012
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