LOGAN JOSE GRANERA

BURLINGTON, IA
NPI1306354147
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: IA  092219)
Additional Taxonomies390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2018-01-15
Last Update Date2018-06-14
Business Address
LOGAN JOSE GRANERA
2743 MOUNT PLEASANT ST
BURLINGTON, IA 52601
Phone number: 319-754-2020
Mailing Address
LOGAN JOSE GRANERA
2743 MOUNT PLEASANT ST
BURLINGTON, IA 52601-2137
Phone number: