Individual
KARL DANIEL GRANROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
620 LEE ST, WINSLOW, AZ 86047-2435
(928) 289-2000
Mailing address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3602
AZ
363AS0400X
Surgical Physician Assistant
3602
AZ
Other
Enumeration date
03/20/2007
Last updated
03/17/2009
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