Granger, Steven Kelly
Granger, Steven Kelly is an sole proprietor health care provider with primary practice located at 465 Ponderosa Dr , Thomaston GA 30286-1356. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Cardiopulmonary, Behavioral Health & Social Service Providers / Poetry Therapist. Behavioral Health & Social Service Providers / Poetry Therapist is his primary health care specialty. Granger, Steven Kelly can be contacted via phone (470) 296-5608.Contact Information
Primary practice address
465 Ponderosa Dr
Thomaston GA 30286-1356
Phone: (470) 296-5608
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Cardiopulmonary | 2251C2600X | ||
| Behavioral Health & Social Service Providers / Poetry Therapist | 102X00000X |
Profile Details
| NPI number | 1467221036 |
|---|---|
| LBN Legal business name | Granger, Steven Kelly |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 25th, 2023 |
| Last updated | Dec 25th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467221036 | NPPES |
| Georgia | MEDICAID | 705007343 |
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