Organization
GRANBY FAMILY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM G DAVIS RN, CS, FNP-C (OWNER/MANAGER)
(417) 472-7200
Entity
Organization
Contact information
Practice address
201 GRANBY MINERS RD, GRANBY, MO 64844-8232
(417) 472-7200
(417) 472-7201
Mailing address
PO BOX 620, GRANBY, MO 64844-0620
(417) 472-7200
(417) 472-7201
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
089423
MO
332B00000X
Durable Medical Equipment & Medical Supplies
089423
MO
332BC3200X
Customized Equipment (DME)
089423
MO
Other
Enumeration date
10/23/2006
Last updated
09/11/2025
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