-- RYAN GRANGE P.A ⚕️ New Mexico 1295194629

NPI	1295194629
Entity Type	Individual
Gender	Male
Sole Proprietor ?	No
Primary Taxonomy	363AM0700X Physician Assistant, Medical (Licence: NM PA 2016-0016)
Enumeration Date	2016-02-12
Last Update Date	2016-04-14

-- RYAN GRANGE P.A

1851 OLD HIGHWAY 66 UNIT 1

EDGEWOOD, NM 87015

Phone number: 505-286-2396

-- RYAN GRANGE P.A

12127B HWY 14 N STE 5

CEDAR CREST, NM 87008-9499

Phone number: 505-281-5180