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1619647989
GRANT FONS
REDFORD, MI
NPI
1619647989
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MI 5601010238)
Enumeration Date
2021-09-17
Last Update Date
2021-09-17
Business Address
GRANT FONS PA
14671 TELEGRAPH RD
REDFORD, MI 48239-3300
Phone number: 313-948-3055
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Mailing Address
GRANT FONS PA
14671 TELEGRAPH RD
REDFORD, MI 48239-3300
Phone number: 313-948-3055
Copy
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