Individual
GARY DEGRANDCHAMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
255 N MIAMI ST, WABASH, IN 46992-2705
(260) 563-8446
(260) 563-1902
Mailing address
850 N HARRISON ST, WARSAW, IN 46580-3163
(574) 267-7169
(574) 269-5573
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/08/2013
Last updated
01/08/2013
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