Individual provider · Type 1 NPI
Ryan Grange, P.A
Medical Physician Assistant · Edgewood, NM
NPI number
1295194629
Active
Practice location
1851 Old Highway 66 Unit 1
Edgewood, NM 87015
Fax (505) 286-2398
Mailing address
12127B Hwy 14 N, Ste 5
Cedar Crest, NM 87008-9499
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | PA 2016-0016 (NM) |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Edgewood
About NPI 1295194629
Ryan Grange, P.A's National Provider Identifier is 1295194629, issued on Feb 12, 2016. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Edgewood, NM. The record was last updated on Apr 14, 2016.