Individual
MARK C. GRANBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
4301 BROADWAY ST, CPO99, SAN ANTONIO, TX 78209-6318
(210) 805-3025
Mailing address
4301 BROADWAY ST, CPO99, SAN ANTONIO, TX 78209-6318
(210) 805-3025
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
41497
TX
Other
Enumeration date
02/09/2007
Last updated
02/06/2009
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