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General NPI Number Information
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NPI Number | 1801409198
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Entity Type | Organization
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Legal Business Name | VOYA HEALTH MEDICAL GROUP, PLLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 139 N 4TH ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1403
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Country | US
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Telephone | 248-761-4683
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Fax |
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Provider Business Mailing Address
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Address Line | 139 N 4TH ST
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City | LEWISBURG
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State | PA
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Zip | 17837-1403
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Country | US
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Telephone | 248-761-4683
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | DR. RYAN A GRANT
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Credential | MD
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Telephone | 248-761-4683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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