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Individual

TAMIE LEA GRANGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
15112 SUNNINGDALE ST, AUSTIN, TX 78717-3818
(512) 364-2945
(512) 248-8611
Mailing address
15112 SUNNINGDALE ST, AUSTIN, TX 78717-3818
(512) 364-2945
(512) 248-8611

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary

Other

Enumeration date
05/07/2009
Last updated
05/07/2009
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