Individual
MS. PATRICIA ELAINE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T/M.M.P.
Contact information
Practice address
120 MANOR DR, PONCHATOULA, LA 70454-2920
(985) 507-7319
Mailing address
120 MANOR DR, PONCHATOULA, LA 70454-2920
(985) 507-7319
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LA # 1476
LA
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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