Organization
VIVIAN NELL HANNON
Active
Other names
Grant Family Practice Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA H GEDLING (OFFICE MANAGER)
(256) 582-6377
Entity
Organization
Contact information
Practice address
5447 MAIN STREET, GRANT, AL 35747-6211
(256) 728-2272
(256) 728-2282
Mailing address
1241 BLOUNT AVE NW, GUNTERSVILLE, AL 35976
(256) 582-6377
(256) 582-6376
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
541003911
—
AL
Enumeration date
01/08/2007
Last updated
03/12/2015
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