Mark Charles Grant

NPI 1477730141 - Chiropractor - 111N00000X

NPI Details
NPI 1477730141
Gender Male
Enumeration Date 01/24/2008
Last Updated 01/24/2008
Entity Type Individual
Active Over 8 years ago
Practice Location
451 PINE LAKE AVE
LA PORTE IN, 46350-2314, US
Phone (219) 362-3766
Fax
Business Location
451 PINE LAKE AVE
LA PORTE IN, 46350-2314, US
Phone
Fax
Toxanomy
Taxonomy Code 111N00000X
License State Indiana
License Number 08001545
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According to our database, Dr. Mark Charles Grant NPI is 1477730141, taxonomy code is 111N00000X and license number is 08001545, license state is located at Indiana. Mark Charles Grant physically located at 451 Pine Lake Ave, La Porte IN, 46350-2314. NPI Number Mark Charles Grant has the Individual type.

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1477730141 NPI number is provided on an as is basis without warranty of any kind. 1477730141 is maintained by the National Plan & Provider Enumeration System. The contents of Mark Charles Grant are for informational purposes only.