Individual
NORMA P GRANDBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
IDMT
Contact information
Practice address
1501 WESTCHESTER ST, CLOVIS, NM 88101-4638
(757) 286-4505
Mailing address
1501 WESTCHESTER ST, CLOVIS, NM 88101-4638
(757) 286-4505
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
12/21/2010
Last updated
12/21/2010
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