Individual
KEVIN J GRANNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1216 DUNCAN RD, COPPERAS COVE, TX 76522-7409
(254) 577-4880
(254) 518-5300
Mailing address
1216 DUNCAN RD, COPPERAS COVE, TX 76522-7409
(254) 577-4880
(254) 518-5300
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
112058
TX
Other
Enumeration date
12/05/2023
Last updated
12/27/2023
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