| Granite Mountain Neurology, Pc | |
|
802 Ainsworth Dr Suite B Prescott AZ 86301-1630 | |
| (928) 771-2338 | |
| (928) 771-2339 |
| Full Name | Granite Mountain Neurology, Pc |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 802 Ainsworth Dr, Prescott, Arizona |
| Authorized Official Name and Position | Donald A Golen (PRESIDENT) |
| Authorized Official Contact | 9287712338 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Granite Mountain Neurology, Pc 802 Ainsworth Dr Suite B Prescott AZ 86301-1630 Ph: (928) 771-2338 | Granite Mountain Neurology, Pc 802 Ainsworth Dr Suite B Prescott AZ 86301-1630 Ph: (928) 771-2338 |
| NPI Number | 1194784900 |
|---|---|
| Provider Enumeration Date | 03/21/2006 |
| Last Update Date | 02/16/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194784900 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 23522 (Arizona) | Primary |
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