Individual
GRANT AUSTIN CIAVARELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
132 ABIGAIL LN, PORT MATILDA, PA 16870-7153
(814) 272-7100
(814) 272-6501
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
OS021010
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2016
Last updated
06/28/2021
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