Individual
MR. JON GRANT
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
A.T.,C.
Contact information
Practice address
8227 NORTHWEST BLVD, SUITE 160, INDIANAPOLIS, IN 46278-1387
(317) 415-5747
(317) 415-5748
Mailing address
12160 LONGSTRAW DR, INDIANAPOLIS, IN 46236-8263
(317) 826-0643
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000235A
IN
Other
Enumeration date
04/06/2006
Last updated
07/08/2007
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