Connie Grand's National Provider Identifier (NPI) Details
Connie Grand, Licensed Professiona
NPI: 1841490323
Enumeration Date: 2007-07-23
Last updated: 2007-07-23
Sole Proprietor: NO
Status: active
Postal Address: ROUTE 1, BOX 408, AVA, MO
Phone: 417-683-1162
Primary Practice Address: 202-1 NW 11TH ST, AVA, MO
Practice's phone: 417-683-4505