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Individual

MR. GRANT WILLIAM VIRTUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
15504 NE 2ND ST, VANCOUVER, WA 98684-3340
(407) 970-4450
Mailing address
15504 NE 2ND ST, VANCOUVER, WA 98684-3340
(407) 970-4450

Taxonomy

Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
NA.00755317
CO

Other

Enumeration date
06/06/2014
Last updated
06/06/2014
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