JACKSON RUSSEL GRANATO

LOUISVILLE, KY
NPI1265115828
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2023-08-10
Last Update Date2024-02-06
Business Address
JACKSON RUSSEL GRANATO
368 CRESCENT SPRING DR
LOUISVILLE, KY 40206-2890
Phone number: 913-653-2289
Mailing Address
JACKSON RUSSEL GRANATO
368 CRESCENT SPRING DR
LOUISVILLE, KY 40206-2890
Phone number: 913-653-2289
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