Individual
GRANT LANNOYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7448 US HWY 281, CANDO, ND 58324-0688
(701) 968-2541
(701) 968-2574
Mailing address
PO BOX 688, CANDO, ND 58324-0688
(701) 968-2541
(701) 968-2574
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PAC0615
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PAC0615
NORTH DAKOTA LICENSE NUMBER
ND
Enumeration date
09/24/2015
Last updated
09/24/2015
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