Individual
DR. GRANT ETNYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
16111 PLUMMER ST, DEPARTMENT OF PHYSICAL MEDICINE (117), NORTH HILLS, CA 91343-2036
(818) 891-7711
(818) 895-9458
Mailing address
16111 PLUMMER ST, DEPARTMENT OF PHYSICAL MEDICINE (117), NORTH HILLS, CA 91343-2036
(818) 891-7711
(818) 895-9458
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
36096765
IL
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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