Granger, Carly Kay

Granger, Carly Kay is an individual health care provider with primary practice located at 13625 White Lake Rd , Fenton MI 48430-8427. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Student, Health Care / Student in an Organized Health Care Education/Training Program. Student, Health Care / Student in an Organized Health Care Education/Training Program is her primary health care specialty. Granger, Carly Kay can be contacted via phone (810) 922-3262.

Contact Information

Primary practice address
13625 White Lake Rd Fenton MI 48430-8427
Phone: (810) 922-3262
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1730829672
LBN Legal business name Granger, Carly Kay
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2022
Last updated Mar 30th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730829672 NPPES
Michigan Other XYQ892727864 BLUECROSS BLUESHIELD

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