Individual
GRANT INGALLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPAS
Contact information
Practice address
120 IRMC DR STE 100, INDIANA, PA 15701-3674
(724) 427-2707
(724) 427-2707
Mailing address
640 KOLTER DR, INDIANA, PA 15701-3570
(724) 427-2762
(724) 427-2707
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA061593
PA
Other
Enumeration date
06/30/2020
Last updated
01/03/2024
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