Travis Vernon Grant

NPI #1134792757 in Vinita, Oklahoma

Provider Information

NPI Number: 1134792757
Entity Type: Individual
Name: Travis Vernon Grant
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Peer Specialist
Enumeration Date: Jul 21, 2021
Last Updated: Jul 21, 2021

Practice Location

Address: 405 E EXCELSIOR AVE.
City: Vinita
State: Oklahoma
ZIP Code: 74301
Phone: (918) 273-1841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

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