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1295221109
JORDAN ALLEN GRANTZ
RICHMOND, VA
NPI
1295221109
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: VA 0131001954)
Enumeration Date
2018-07-03
Last Update Date
2018-07-03
Business Address
JORDAN ALLEN GRANTZ COTA/L
2125 HILLIARD RD
RICHMOND, VA 23228-4600
Phone number: 804-266-9666
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Mailing Address
JORDAN ALLEN GRANTZ COTA/L
9421 EVERETTE CT
SPOTSYLVANIA, VA 22553-1978
Phone number:
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