Individual
CORY MYGRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RDN
Contact information
Practice address
9347 PENDLETON PIKE, INDIANAPOLIS, IN 46236-2768
(260) 359-2444
Mailing address
9347 PENDLETON PIKE, INDIANAPOLIS, IN 46236-2768
(260) 359-2444
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86061086
IN
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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