Individual
DAVID GRIZZARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1800 BEACH DR, GULFPORT, MS 39507-1553
(228) 897-4452
(228) 897-4481
Mailing address
PO BOX 8419, BILOXI, MS 39535-8087
(228) 388-5714
(228) 388-0017
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT2521
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09015077
—
MS
01
—
1033218524
GROUP NPI
MS
Enumeration date
08/11/2016
Last updated
08/11/2016
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