Individual
GRANT PETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
9641 BROOKDALE DR, CHARLOTTE, NC 28215-8706
(704) 599-8449
Mailing address
9641 BROOKDALE DR, CHARLOTTE, NC 28215-8706
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
27343
NC
Other
Enumeration date
10/28/2017
Last updated
10/28/2017
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