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Individual

JAVIROUS DEVONTAY GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
7244 HALCYON PARK DR, MONTGOMERY, AL 36117-7717
(334) 401-2361
Mailing address
3164 PARTRIDGE RD, MONTGOMERY, AL 36111-3022
(334) 221-8808

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2854
AL

Other

Enumeration date
06/03/2024
Last updated
06/03/2024
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