DIANE TACKIE GRANILLO, LLC

TOWSON, MD
NPI1972393171
Entity TypeOrganization
Authorized ContactDIANE TACKIE GRANILLO
Owner
202-951-7942
Organization Subpart ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
Enumeration Date2025-05-09
Last Update Date2025-10-07
Business Address
DIANE TACKIE GRANILLO, LLC
40 YORK RD STE 110
TOWSON, MD 21204-5243
Phone number: 202-951-7942
Mailing Address
DIANE TACKIE GRANILLO, LLC
40 YORK RD STE 110
TOWSON, MD 21204-5243
Phone number: 202-951-7942