Individual
DENISE RENEE GRIDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC, CSCS, PES
Contact information
Practice address
801 W ESSEX AVE, KIRKWOOD, MO 63122-3608
(314) 213-6100
Mailing address
614 BRIAR LAKE PL, COLUMBIA, IL 62236-2751
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2007031478
MO
Other
Enumeration date
11/02/2011
Last updated
11/02/2011
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