Danny Grant
Clinic/Center, Primary Care in Fort Stewart, GA. Individual provider (NPI-1).
NPI number1699166124
StatusActive
Last updated in NPPESFeb 5, 2015
Details
- NPI
- 1699166124
- Entity type
- Individual (NPI-1)
- Name
- Danny Grant
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 5, 2015
- Last updated
- Feb 5, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 91590 | SC | Yes |
Practice location
192 Lindquist RdFort Stewart, GA 31314-5000
Phone 912-435-5662
Mailing address
1140 Pine Grove RdBlythewood, SC 29016-9790
Phone 912-435-5662
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