Organization
MARIE J GRAVEL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIE J GRAVEL PA-C (PRESIDENT)
(954) 592-4292
Entity
Organization
Contact information
Practice address
3850 OAKS CLUBHOUSE DR, SUITE 206, POMPANO BEACH, FL 33069-3668
(954) 592-4292
Mailing address
3850 OAKS CLUBHOUSE DR, SUITE 206, POMPANO BEACH, FL 33069-3668
(954) 592-4292
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA3729
FL
Other
Enumeration date
12/10/2007
Last updated
12/10/2007
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