Individual
VILMA GRANGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
580 TOMMY LEE FULLER DR, LOGANVILLE, GA 30052-3943
(770) 466-7388
Mailing address
1441 YORKTON CT, STONE MOUNTAIN, GA 30083-5549
(301) 792-8085
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA001741
GA
Other
Enumeration date
05/26/2014
Last updated
05/26/2014
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