Granger Medical Clinic, PC

NPI #1649541699 in Riverton, Utah

Provider Information

NPI Number: 1649541699
Entity Type: Organization
Organization Name: Granger Medical Clinic, PC
Subpart: Yes (part of a larger organization)
Parent Organization: GRANGER MEDICAL CLINIC, PC
Primary Specialty: Family Medicine
Enumeration Date: Jan 23, 2012
Last Updated: Mar 2, 2015

Practice Location

Address: 1288 W 12700 S
City: Riverton
State: Utah
ZIP Code: 84065-6794
Phone: (801) 253-3500

Authorized Official

Name: MRS. ANNE WHITAKER
Title: CREDENTIALING COORDINATOR
Phone: (801) 965-3505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X
Family Medicine	207Q00000X	Primary

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