| NPI Details | |
|---|---|
| NPI | 1174623433 |
| Gender | Male |
| Enumeration Date | 09/25/2006 |
| Last Updated | 01/19/2009 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 709 TOWNES COURT PEORIA IL, 61615-1387, US |
|
| Phone | (309) 692-5550 |
| Fax | (309) 692-5553 |
| Business Location | |
|---|---|
| 709 TOWNES COURT PEORIA IL, 61615-1387, US |
|
| Phone | (309) 692-5550 |
| Fax | (309) 692-5553 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 2084F0202X |
| License State | Illinois |
| License Number | 036-066475 |
| Remove 1174623433 NPI Number | |
According to our database, Richard Locke Grant M.D. NPI is 1174623433, taxonomy code is 2084F0202X and license number is 036-066475, license state is located at Illinois. Richard Locke Grant M.D. physically located at 709 Townes Court, Peoria IL, 61615-1387. NPI Number Richard Locke Grant M.D. has the Individual type.
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1174623433 NPI number is provided on an as is basis without warranty of any kind. 1174623433 is maintained by the National Plan & Provider Enumeration System. The contents of Richard Locke Grant M.D. are for informational purposes only.
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