AUSTIN GRANT

BENTON, IL
NPI1063025781
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy164W00000X Licensed Practical Nurse
(Licence: IL  043.129163)
Enumeration Date2020-08-24
Last Update Date2020-08-24
Business Address
AUSTIN GRANT LPN
205 JOPLIN ST
BENTON, IL 62812-2023
Phone number: 618-603-6209
Mailing Address
AUSTIN GRANT LPN
205 JOPLIN ST
BENTON, IL 62812-2023
Phone number: 618-603-6209
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