Individual
MR. LEE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
39 DEPOT ST, BAR MILLS, ME 04004-0462
(207) 284-3883
Mailing address
39 DEPOT ST, PO BOX 462, BAR MILLS, ME 04004-0462
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT2153
ME
Other
Enumeration date
11/30/2011
Last updated
11/30/2011
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