Sara T Granville, PA

NPI #1457670366 in Pierre, South Dakota

Provider Information

NPI Number: 1457670366
Entity Type: Individual
Name: Sara T Granville, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: May 18, 2010
Last Updated: Apr 13, 2012

Practice Location

Address: 100 MAC LN
Address 2: AVERA MEDICAL GROUP PIERRE
City: Pierre
State: South Dakota
ZIP Code: 57501
Phone: (605) 945-5202

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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