Individual
LANA E GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12502 WILLOWBROOK RD STE 470, CUMBERLAND, MD 21502-6593
(240) 964-8724
(240) 964-8735
Mailing address
PO BOX 1671, CUMBERLAND, MD 21501-1671
(240) 964-8342
(240) 964-8337
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C06457
MD
Other
Enumeration date
06/05/2017
Last updated
07/21/2022
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