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MISS TIFFANI L GRANT LD

Dietary & Nutritional Service Providers Nutritionist Nutrition, Education

Provider NPI: 1770770117

Provider Information:
MISS TIFFANI L GRANT LD
Gender: F
Not Sole Proprietor

Practice Location:
2500 NORTH STATE STREET DEPARTMENT OF MEDICINE/DIVISION OF GENERAL INTERNAL MED JACKSON, MS 39216-4500 US
Tel: 601-984-5660  Fax: --

Business Mailing Address:
P.O. BOX 24146 UNIVERSITY PHYSICIANS, PLLC JACKSON, MS 39225-4146 US
Tel: 601-984-5660  Fax: 601-984-6870

NPI Information:
NPI: 1770770117
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y133NN1002XDietary & Nutritional Service Providers
Nutritionist
Nutrition, Education
MSD1248

Other Provider Identifiers:

IssuerNumberStateType



American Medical Association 2012 taxonomy code information

Code: 133NN1002X

Type:

Classification:



Definition:



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