Individual
LAURA GRANTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1 E CLARK BASS BLVD, MCALESTER, OK 74501-4209
(918) 426-1800
Mailing address
PO BOX 1992, MCALESTER, OK 74502-1992
(918) 426-2442
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
210625
OK
Other
Enumeration date
10/24/2022
Last updated
03/25/2025
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