| NPI | 1023611944 |
|---|---|
| Other Name | TA GRANT WELLNESS |
| Entity Type | Organization |
| Authorized Contact | TITILAYO GRANT Nurse Practitioner/Manager 520-233-4585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2020-11-21 |