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1770939159
GRANT LARIE
DE PERE, WI
NPI
1770939159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
111N00000X Chiropractor
(Licence: WI 5174-12)
Enumeration Date
2016-05-04
Last Update Date
2016-05-04
Business Address
-- GRANT LARIE D.C.
502 GEORGE ST
DE PERE, WI 54115-2714
Phone number: 920-337-0103
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Mailing Address
-- GRANT LARIE D.C.
502 GEORGE ST
DE PERE, WI 54115-2714
Phone number: 920-337-0103
Copy
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