Individual
MS. CAROLE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LD,CNSC
Contact information
Practice address
200 WEST HOSPITAL DRIVE, WHITERIVER, AZ 85941
(928) 338-3647
Mailing address
1081 E CEDAR RIDGE RUN, SHOW LOW, AZ 85901-7308
(928) 338-3647
(928) 338-3522
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
LD003592
GA
Other
Enumeration date
10/22/2010
Last updated
03/23/2012
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