Most Relevant Information
Provider Data
| NPI Number: | 1003554916 |
| Provider Name: | DEBRA JO GRANT |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 05/22/2022 |
| Last Updated: | 05/22/2022 |
Provider Practice Location
5905 O ST
LINCOLN
NE
685102235
Practice Location Phone/Fax
| Phone: | 4024361000 |
| Fax: |
Provider Mailing Location
5905 O ST
LINCOLN
NE
685102235
Provider Mailing Phone/Fax
| Phone: | 4024361000 |
| Fax: |