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Individual

EDDIE GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1001 CHASELAKE DR, JONESBORO, GA 30236-7740
(678) 558-8041

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
RPT 37820
FL

Other

Enumeration date
11/14/2015
Last updated
11/14/2015
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