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Individual

DANNY GRANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
192 LINDQUIST RD, FORT STEWART, GA 31314-5000
(912) 435-5662
Mailing address
1140 PINE GROVE RD, BLYTHEWOOD, SC 29016-9790
(912) 435-5662

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
91590
SC

Other

Enumeration date
02/05/2015
Last updated
02/05/2015
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