Medaisle Express, LLC

NPI #1194902916 in Reno, Nevada

Provider Information

NPI Number: 1194902916
Entity Type: Organization
Organization Name: Medaisle Express, LLC
Primary Specialty: Family Medicine
Enumeration Date: Jan 23, 2008
Last Updated: Mar 4, 2008

Practice Location

Address: 6180 MAE ANNE AVE
Address 2: SUITE 2
City: Reno
State: Nevada
ZIP Code: 89523-4700
Phone: (775) 284-5556

Authorized Official

Name: WESLEY GRANSTROM
Title: OWNER
Phone: (775) 284-5556

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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