Individual
MR. CODY RAY GRANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-7000
Mailing address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
126162
AR
Other
Enumeration date
07/23/2008
Last updated
06/26/2019
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