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1306982780
SUZETTE M GRANT
COLUMBIA FALLS, ME
NPI
1306982780
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
305R00000X Preferred Provider Organization
(Licence: ME 3002032)
Enumeration Date
2007-01-30
Last Update Date
2007-07-08
Business Address
Ms. SUZETTE M GRANT individual
860 TIBBETTSTOWN RD
COLUMBIA FALLS, ME 04623-5021
Phone number: 207-483-2883
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Mailing Address
Ms. SUZETTE M GRANT individual
860 TIBBETTSTOWN RD
COLUMBIA FALLS, ME 04623-5021
Phone number: 207-483-2883
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