Individual
ABIGAIL RENEE GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
123 MAIN AVE, NITRO, WV 25143-1270
(304) 550-7153
Mailing address
123 MAIN AVE, NITRO, WV 25143-1270
(304) 550-7153
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/11/2020
Last updated
02/11/2020
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