Individual
SEAN DARRIEUS GRISSETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 N BAILEY ST, PRYOR, OK 74361-4201
(918) 824-7770
Mailing address
111 N BAILEY ST, PRYOR, OK 74361-4201
(918) 824-7770
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
700
OK
Other
Enumeration date
08/15/2019
Last updated
08/15/2019
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