Organization
GRITMAN MEDICAL CENTER INC
Active
Other names
Gritman Pulmonology
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANIELLE LYNAS (CFO)
(208) 883-2220
Entity
Organization
Contact information
Practice address
700 S MAIN ST, MOSCOW, ID 83843-3046
(208) 883-6779
(208) 883-8430
Mailing address
PO BOX 8007, MOSCOW, ID 83843-0507
(208) 883-6779
(208) 883-8430
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Enumeration date
06/14/2019
Last updated
06/14/2019
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