Individual
BRIAN SCOTT GRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
173 M 66 N, CHARLEVOIX, MI 49720-9338
(231) 903-4620
Mailing address
173 M 66 N, CHARLEVOIX, MI 49720-9338
(231) 903-4620
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
Primary
3501008986
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3501008986
HEARING AID SALES LICENSE MICHIGAN
MI
Enumeration date
04/04/2018
Last updated
04/04/2018
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