Individual
DR. OLIVIA GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
US RT 119 HOLDEN RD, MOUNT GAY, WV 25637
(304) 239-2380
Mailing address
US RT 119 HOLDEN RD, MOUNT GAY, WV 25637
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0007560
WV
Other
Enumeration date
01/05/2011
Last updated
01/05/2011
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