Individual
MERVEILLE N GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
600 GUY PAINE RD BLDG 102, MACON, GA 31206-2069
(478) 227-0056
Mailing address
3123 CLAIRMONT AVE, MACON, GA 31204-1005
(912) 358-7951
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
09/30/2021
Last updated
10/22/2021
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