Individual
RACHEL MARIE GRANQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-6337
Mailing address
680 CENTRE ST, BROCKTON, MA 02302-3308
(508) 941-7000
(508) 941-6337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1117
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200283
—
MA
Enumeration date
06/19/2007
Last updated
07/09/2007
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