Organization
GRUNER CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RACHEL MIER GRUNER M.D. (OWNER)
(225) 658-5959
Entity
Organization
Contact information
Practice address
6180 MAIN ST, SUITE B, ZACHARY, LA 70791-4069
(225) 658-5959
(225) 658-9998
Mailing address
6180 MAIN ST, SUITE B, ZACHARY, LA 70791-4069
(225) 658-5959
(225) 658-9998
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
024988
LA
208600000X
Surgery Physician
023672
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1444821
—
LA
Enumeration date
08/23/2007
Last updated
08/23/2007
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