Organization
GRITMAN MEDICAL CENTER INC
Active
Other names
Gritman Interventional Pain Management Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DANIELLE LYNAS (CFO)
(208) 883-2220
Entity
Organization
Contact information
Practice address
804 S WASHINGTON ST STE A, MOSCOW, ID 83843-3182
(208) 883-6700
Mailing address
700 S MAIN ST, MOSCOW, ID 83843-3046
Taxonomy
Speciality
Code
Description
License number
State
208VP0014X
Interventional Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/31/2019
Last updated
12/31/2019
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