Individual
KIRSTIN GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
(959) 201-8410
Mailing address
365 MONTAUK AVE, NEW LONDON, CT 06320-4700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6285
CT
Other
Enumeration date
09/28/2016
Last updated
07/09/2024
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