Individual
MONA MYNNEL TARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
714 NW 5TH ST, GRANTS PASS, OR 97526-1529
(541) 244-2292
(541) 244-2292
Mailing address
714 NW 5TH ST, GRANTS PASS, OR 97526-1529
(541) 244-2292
(541) 244-2292
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD15235
OR
Other
Enumeration date
10/17/2005
Last updated
12/01/2010
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