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1043286222
MARK A GRANRUD
NAMPA, ID
NPI
1043286222
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA621)
Enumeration Date
2006-02-27
Last Update Date
2007-07-08
Business Address
-- MARK A GRANRUD PA-C
215 E HAWAII AVENUE
NAMPA, ID 83686
Phone number: 208-463-3000
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Mailing Address
-- MARK A GRANRUD PA-C
217 W GEORGIA SUITE 115
NAMPA, ID 83686
Phone number: 208-463-3000
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