Provider Demographics
NPI:1225577679
Name:TURLEY, GRANT
Entity Type:Individual
Prefix:
First Name:GRANT
Middle Name:
Last Name:TURLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2830 LAKE RD
Mailing Address - Street 2:APT 515
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-5640
Mailing Address - Country:US
Mailing Address - Phone:208-403-4090
Mailing Address - Fax:
Practice Address - Street 1:2830 LAKE RD
Practice Address - Street 2:APT 515
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-5640
Practice Address - Country:US
Practice Address - Phone:208-403-4090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-17
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other