Individual
MITCHELL GRANT GRANT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAA
Contact information
Practice address
175 W B ST STE D, SPRINGFIELD, OR 97477-4575
(541) 762-1971
(541) 762-1974
Mailing address
175 W B ST STE D, SPRINGFIELD, OR 97477-4575
(541) 762-1971
(541) 762-1974
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/17/2022
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