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1477730141
MARK CHARLES GRANT
LA PORTE, IN
NPI
1477730141
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
111N00000X Chiropractor
(Licence: IN 08001545)
Enumeration Date
2008-01-24
Last Update Date
2008-01-24
Business Address
DR. MARK CHARLES GRANT
451 PINE LAKE AVE
LA PORTE, IN 46350-2314
Phone number: 219-362-3766
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Mailing Address
DR. MARK CHARLES GRANT
451 PINE LAKE AVE
LA PORTE, IN 46350-2314
Phone number:
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