| NPI | 1083849780 |
|---|---|
| Doing Business As | GRANNIS MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | BOB ELLZEY CEO 479-394-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2009-05-26 |