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Individual

MR. RAYNARD LEVON GRANGE II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
672 SUFFOLK ST STE 100, LOWELL, MA 01854-3659
(978) 674-6700
Mailing address
672 SUFFOLK ST STE 100, LOWELL, MA 01854-3659
(978) 674-6700

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
220712
MA

Other

Enumeration date
10/11/2018
Last updated
10/11/2018
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