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Organization

BIOGENICS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SCOTT WAYNE GRANTHAM MPT (OWNER/PHYSICAL THERAPIST)
(601) 906-3718
Entity
Organization

Contact information

Practice address
307 CHARTRESE DR, BRANDON, MS 39047-8779
(601) 906-3718
Mailing address
307 CHARTRESE DR, BRANDON, MS 39047-8779

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
PT3612
MS

Other

Enumeration date
05/19/2015
Last updated
05/19/2015
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