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Individual

DR. JULIA E GRIESEMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-8364
(417) 820-7136
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
106903
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1033252945
MO
05
126001001
AR
01
13884
MO BLUE SHIELD
MO
01
81698
ARK BLUE SHIELD
AR
Enumeration date
02/14/2007
Last updated
07/02/2013
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