Individual
JORDAN J GRNAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5 S LEWIS PLZ, GREENVILLE, SC 29605-2944
(864) 242-4122
Mailing address
5 S LEWIS PLZ, GREENVILLE, SC 29605-2944
(864) 242-4122
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101025371
MI
207R00000X
Internal Medicine Physician
Primary
MDO.83463
SC
Other
Enumeration date
03/13/2018
Last updated
06/28/2021
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