Individual
JOHNATHAN K GRANDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
35 MEDICAL CENTER PARKWAY, AUGUSTA, ME 04330
(207) 877-3400
(207) 877-3401
Mailing address
200 CORPORATE BLVD, LAFAYETTE, LA 70508-3870
(800) 893-9698
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
010477
NY
Other
Enumeration date
07/05/2006
Last updated
08/01/2018
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