Individual
MR. JERRY GRANT GRISWOLD II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NURSE'S AIDE
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
02/19/2019
Last updated
02/19/2019
Update your record
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