Individual
DR. MARY ALYSTER GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
385
NV
152WP0200X
Pediatric Optometrist
385
NV
152WV0400X
Vision Therapy Optometrist
385
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002502100
—
NV
Enumeration date
03/26/2006
Last updated
02/15/2018
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