Individual
COURTNEY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 N 3RD ST, LOMPOC, CA 93436-7002
(805) 736-1253
(805) 736-5355
Mailing address
1515 E OCEAN AVE, LOMPOC, CA 93436-7092
(805) 737-3300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
11/08/2023
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