Organization
INNOVATIVE GASTROENTEROLOGY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOSONDRA GRANT (MEDICAL BILLING MANAGER)
(770) 485-1447
Entity
Organization
Contact information
Practice address
6210 SCOTT ST, SUITE 216, PUNTA GORDA, FL 33950-3901
(941) 378-3871
Mailing address
6210 SCOTT ST, SUITE 216, PUNTA GORDA, FL 33950-3901
(941) 378-3871
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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