Individual
GRANT KNOWLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
405 BOYD LN, MONMOUTH, OR 97361-1611
(503) 838-1244
(503) 837-0313
Mailing address
506 MAIN ST, DALLAS, OR 97338-1915
(503) 623-9233
(503) 623-9233
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3614ATI
OR
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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