NPI | 1003148081 |
---|---|
Doing Business As | GRANITE CREEK FAMILY MEDICINE |
Entity Type | Organization |
Authorized Contact | JENNIFER ROSE BOOZER President 909-450-1571 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA 2OA8927) |
Enumeration Date | 2010-02-02 |
Last Update Date | 2010-02-02 |