Grand Anesthesiology Services PC

NPI #1477567246 in Jackson, Wyoming

Provider Information

NPI Number: 1477567246
Entity Type: Organization
Organization Name: Grand Anesthesiology Services PC
Primary Specialty: Anesthesiology
Enumeration Date: Jul 28, 2006
Last Updated: Mar 3, 2008

Practice Location

Address: 625 E BROADWAY
City: Jackson
State: Wyoming
ZIP Code: 83001
Phone: (800) 877-7078

Authorized Official

Name: MR. MARC DOMSKY, D.O.
Title: PRESIDENT
Phone: (307) 739-7218

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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