Individual
DR. CAMILLE ROSE GRANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-6950
Mailing address
2109 PRESTON LN, MODESTO, CA 95355-2626
(209) 380-0929
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH 61143
CA
Other
Enumeration date
11/22/2010
Last updated
11/22/2010
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