# MEDICAL FIREFIGHTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1003155474
- **Authorized official:** GRACE HERCL D.O. (PHYSICIAN)
- **Authorized official phone:** (509) 420-5125

## Contact information

- **Practice address:** CORNER OF N12 & N7, FD 2371 RED ROCK CIRCLE, FORT DEFIANCE, AZ 86504
- **Practice address phone:** (509) 420-5125
- **Practice address fax:** (614) 861-5537
- **Mailing address:** PO BOX 2331, FORT DEFIANCE, AZ 86504-2331
- **Mailing address phone:** (509) 420-5125
- **Mailing address fax:** (614) 861-5537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208M00000X | Hospitalist Physician | OP 60046454 | WA | Yes |

## Other

- **Enumeration date:** 02/05/2013
- **Last updated:** 11/23/2016