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Individual

SARA T GRANVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
100 MAC LN, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5202
(605) 945-5094
Mailing address
100 MAC LN, AVERA MEDICAL GROUP PIERRE, PIERRE, SD 57501
(605) 945-5202
(605) 945-5094

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
745
SD
363A00000X
Physician Assistant

Other

Enumeration date
05/18/2010
Last updated
04/13/2012
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