Organization
GRITMAN MEDICAL CENTER INC
Active
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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