Individual
WILFORD GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
616 QUINDARO BLVD, KANSAS CITY, KS 66101-1356
(913) 208-9378
(913) 766-1901
Mailing address
616 QUINDARO BLVD, KANSAS CITY, KS 66101-1356
(913) 208-9378
(913) 766-1901
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
G201336013
KS
Other
Enumeration date
09/27/2013
Last updated
09/27/2013
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