Individual
MR. AUSTIN MITCHELL GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1001 SAM PERRY BLVD, FREDERICKSBURG, VA 22401-4453
(540) 741-1167
(540) 741-1164
Mailing address
3210 SYDENHAM ST, FAIRFAX, VA 22031-4844
(757) 647-1897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003070
VA
Other
Enumeration date
08/10/2009
Last updated
02/27/2021
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