Individual
DANIEL GRANTHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
14500 CROOKED SKYA, ARIVACA, AZ 85601-0264
(520) 398-9151
Mailing address
PO BOX 264, ARIVACA, AZ 85601-0264
(520) 398-9151
Taxonomy
Speciality
Code
Description
License number
State
385HR2055X
Child Mental Illness Respite Care
Primary
8637
AZ
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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