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1710386891
KELLY GRANT
CANTON, MI
NPI
1710386891
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
163WA0400X Registered Nurse, Addiction (Substance Use Disorder)
(Licence: MI 4704191116)
Enumeration Date
2014-08-14
Last Update Date
2014-09-02
Business Address
-- KELLY GRANT
43825 MICHIGAN AVE
CANTON, MI 48188-2551
Phone number: 734-397-3088
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Mailing Address
-- KELLY GRANT
43825 MICHIGAN AVE
CANTON, MI 48188-2551
Phone number: 734-397-3088
Copy
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