Organization
LEE GRANT LMT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE M GRANT LMT (MASSAGE THERAPIST)
12072843883
Entity
Organization
Contact information
Practice address
39 DEPOT ST, BUXTON, ME 04093-3944
(120) 728-4388
Mailing address
39 DEPOT ST, BUXTON, ME 04093-3944
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
MT2153
ME
Other
Enumeration date
05/11/2017
Last updated
05/11/2017
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