Individual
PATRICK GRANNEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
505 N 25TH ST, OZARK, MO 65721
(417) 581-3548
(417) 581-6164
Mailing address
505 N 25TH ST, OZARK, MO 65721-9069
(417) 581-3548
(417) 581-6164
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2018014589
MO
Other
Enumeration date
06/11/2015
Last updated
06/26/2018
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