Individual
MIYAH GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3700 W KILGORE AVE, MUNCIE, IN 47304-4810
(765) 289-5437
Mailing address
2205 N DELAWARE ST APT 309, INDIANAPOLIS, IN 46205-4392
(419) 870-5635
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
08/27/2018
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