Individual
MS. MADELINE GRAINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPAS
Contact information
Practice address
743 EAST 300 SOUTH, SALT LAKE CITY, UT 84102
(801) 428-3500
(385) 227-8362
Mailing address
743 EAST 300 SOUTH, SALT LAKE CITY, UT 84102
(801) 428-3500
(385) 227-8362
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
—
—
363A00000X
Physician Assistant
Primary
12364386-1206
UT
Other
Enumeration date
10/06/2016
Last updated
09/24/2021
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