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Individual

DR. LONN J GRANDIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
0224 RENDLEMAN HALL, EDWARDSVILLE, IL 62026-1055
(618) 650-2842
Mailing address
GENERAL DELIVERY, HARDIN, IL 62047-9999

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
IL

Other

Enumeration date
04/19/2007
Last updated
07/08/2007
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