Organization
GRANT INTERNAL MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GRANT MD (PRESIDENT)
(307) 362-9041
Entity
Organization
Contact information
Practice address
2908 FOOTHILL BLVD STE B, ROCK SPRINGS, WY 82901-4956
(307) 362-9041
(307) 362-9461
Mailing address
2908 FOOTHILL BLVD STE B, ROCK SPRINGS, WY 82901-4956
(307) 362-9041
(307) 362-9461
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6367A
WY
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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