Granite City Clinic Corp
NPI #1003892464 in Granite City, Illinois
Provider Information
- NPI Number
- 1003892464
- Entity Type
- Organization
- Organization Name
- Granite City Clinic Corp
- Primary Specialty
- Nurse Anesthetist, Certified Registered
- Enumeration Date
- Dec 19, 2005
- Last Updated
- Jul 30, 2007
Practice Location
- Address
- 2100 MADISON AVE
- City
- Granite City
- State
- Illinois
- ZIP Code
- 62040-4701
- Phone
- (618) 798-3000
Authorized Official
- Name
- GARY NEWSOME
- Title
- VP
- Phone
- (615) 465-7000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Anesthesiology |
| Nurse Anesthetist, Certified Registered |
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