Individual
BLAIR GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6465 GREENWOOD PLAZA BLVD, SUITE 300, CENTENNIAL, CO 80111-4905
(303) 267-3596
Mailing address
5335 FLYING S LN, COLORADO SPRINGS, CO 80915-2400
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
122525
CO
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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