Most Relevant Information
Provider Data
| NPI Number: | 1003597956 |
| Provider Name: | GISELLE GRANADOS OWNER |
| Entity Type: | Individual |
| Taxonomy Code: | 2471V0105X |
| Specialty: | Radiologic Technologist |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/25/2023 |
| Last Updated: | 07/25/2023 |
Provider Practice Location
810 W DOUGLAS AVE STE C
WICHITA
KS
672036133
Practice Location Phone/Fax
| Phone: | 3162028701 |
| Fax: |
Provider Mailing Location
5335 S STONEBOROUGH ST
WICHITA
KS
672176512
Provider Mailing Phone/Fax
| Phone: | 3162028701 |
| Fax: |