Individual
DR. GARY J. GRANGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
107 CENTRE SARCELLE BLVD., SUITE 704, YOUNGSVILLE, LA 70592-6193
(337) 451-4511
(337) 857-6044
Mailing address
107 CENTRE SARCELLE BLVD., SUITE 704, YOUNGSVILLE, LA 70592-6193
(337) 451-4511
(337) 857-6044
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1611-644T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2167626
—
LA
Enumeration date
08/01/2011
Last updated
12/17/2014
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