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1457670366
SARA T GRANVILLE
PIERRE, SD
NPI
1457670366
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: SD 745)
Additional Taxonomies
363A00000X Physician Assistant
Enumeration Date
2010-05-18
Last Update Date
2012-04-13
Business Address
-- SARA T GRANVILLE PA
100 MAC LN AVERA MEDICAL GROUP PIERRE
PIERRE, SD 57501
Phone number: 605-945-5202
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Mailing Address
-- SARA T GRANVILLE PA
100 MAC LN AVERA MEDICAL GROUP PIERRE
PIERRE, SD 57501
Phone number: 605-945-5202
Copy
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