| Mary E Grandon, PA-C | |
|
107 Koontz Ave. Ste. 200, Clendenin, WV 25045 | |
| (304) 548-7272 | |
| (304) 548-7149 |
| Full Name | Mary E Grandon |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 107 Koontz Ave. Ste. 200, Clendenin, West Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790754638 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 00616 (West Virginia) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mary E Grandon, PA-C Po Box 70, Dawes, WV 25054 Ph: (304) 734-2040 | Mary E Grandon, PA-C 107 Koontz Ave. Ste. 200, Clendenin, WV 25045 Ph: (304) 548-7272 |
Rachael D. Mitchell, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-548-7149 | |
Chelsea Agnew, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 | |
Ms. Jennifer Lynn Thayer, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-548-7149 | |
Trenton Ryan Johnson, Physician Assistant Medicare: Medicare Enrolled Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-542-7149 |