Organization
GRANT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARC B GRANT D.O. (PRESIDENT)
(928) 468-1337
Entity
Organization
Contact information
Practice address
708 S COEUR D ALENE LN, SUITE D, PAYSON, AZ 85541-5662
(925) 468-1337
(928) 468-1339
Mailing address
708 S COEUR D ALENE LN, SUITE D, PAYSON, AZ 85541-5662
(925) 468-1337
(928) 468-1339
Taxonomy
Speciality
Code
Description
License number
State
207LA0401X
Addiction Medicine (Anesthesiology) Physician
Primary
1609
AZ
Other
Enumeration date
08/08/2013
Last updated
08/08/2013
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