Provider Demographics
NPI:1770255630
Name:GRUNTMANE, MARTA (PA-C)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:
Last Name:GRUNTMANE
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:521 ELM ST
Mailing Address - Street 2:
Mailing Address - City:LEADVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80461-3913
Mailing Address - Country:US
Mailing Address - Phone:214-578-6698
Mailing Address - Fax:
Practice Address - Street 1:230 CHAPEL SQ UNIT D-102
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CO
Practice Address - Zip Code:81620-6497
Practice Address - Country:US
Practice Address - Phone:970-945-2840
Practice Address - Fax:970-945-2893
Is Sole Proprietor?:No
Enumeration Date:2021-09-29
Last Update Date:2023-08-01
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant