Healthcare Provider Details

I. General information

NPI: 1598520165
Provider Name (Legal Business Name): GRANT THOMAS BARTEE P.E.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2024
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1473 MONROE RD
LEBANON OH
45036-1422
US

IV. Provider business mailing address

1473 MONROE RD
LEBANON OH
45036-1422
US

V. Phone/Fax

Practice location:
  • Phone: 937-657-6278
  • Fax:
Mailing address:
  • Phone: 937-657-6278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171WH0202X
TaxonomyHome Modifications Contractor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: