Individual provider · NPI-1

Alecia Grant

Technician, Other · Lakeland, FL

NPI number1689262669
StatusActive
Last updated in NPPESJan 6, 2021

Details

NPI
1689262669
Entity type
Individual (NPI-1)
Name
Alecia Grant
Sex
Female
Sole proprietor
No
Enumeration date
Jan 6, 2021
Certification date
Jan 6, 2021
Last updated
Jan 6, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
247200000X Technician, Other––Yes

Practice location

1835 Gilmore Ave
Lakeland, FL 33805-3017

Phone 863-519-0575 · Fax 863-582-9251

Mailing address

Po Box 1559
Bartow, FL 33831-1559

Phone 863-519-0575 · Fax 863-582-9251

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