Individual
MRS. CARMEN S. GRANDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-2000
(859) 426-4140
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 301-2000
(859) 426-4140
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50-001929
OH
363A00000X
Physician Assistant
Primary
PA951
KY
Other
Enumeration date
05/04/2006
Last updated
06/07/2023
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