Individual
MR. RICHARD GRANDVILLE MICHAEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1311 WOODCASTLE RD, NIXA, MO 65714-7183
(417) 725-9302
Mailing address
1311 WOODCASTLE RD, NIXA, MO 65714-7183
(417) 725-9302
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
042027
MO
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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