Individual
MR. JARED MATTHEW GRZANICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 649-6880
Mailing address
180 S MAIN ST, CANTON, IL 61520-2608
(309) 647-0201
(309) 647-8613
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085003182
IL
Other
Enumeration date
02/28/2008
Last updated
04/13/2021
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