Individual
JILL ANN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
75 BROCKWAY RD, WOODSTOCK VALLEY, CT 06282-2703
(860) 974-1174
Mailing address
75 BROCKWAY RD, WOODSTOCK VALLEY, CT 06282-2703
(860) 974-1174
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/23/2019
Last updated
07/23/2019
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