| Katie Grant | |
|
1800 3rd Ave Suite 612 Rock Island IL 61201-8026 | |
| (563) 676-6136 | |
| (815) 377-2599 |
| Full Name | Katie Grant |
|---|---|
| Speciality | Counselor - Professional |
| Location | 1800 3rd Ave, Rock Island, Illinois |
| Authorized Official Name and Position | Katie Grant (OWNER) |
| Authorized Official Contact | 5636766136 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Katie Grant 528 W 30th St Davenport IA 52803-1016 Ph: (563) 676-6136 | Katie Grant 1800 3rd Ave Suite 612 Rock Island IL 61201-8026 Ph: (563) 676-6136 |
| NPI Number | 1902149115 |
|---|---|
| Provider Enumeration Date | 04/05/2013 |
| Last Update Date | 04/05/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902149115 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180.007951 (Illinois) | Primary |
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