Individual
MRS. GERALDINE L. C. GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BOC 10400
Contact information
Practice address
1 JARRETT WHITE RD, ORTHOPEDIC BRACE CLINIC, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-6967
Mailing address
1 JARRETT WHITE RD, ORTHOPEDIC BRACE CLINIC, TRIPLER ARMY MEDICAL CENTER, HI 96859-5001
(808) 433-6967
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10400
BOARD OF CERTIFICATION/ACCREDITATION, INTERNATIONAL
MD
Enumeration date
11/21/2011
Last updated
11/21/2011
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