Individual
DAVID EDWARD GRISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, OTC, R.T. (R)
Contact information
Practice address
3136 W MALDONADO RD, PHOENIX, AZ 85041-6371
(480) 518-5552
Mailing address
3136 W MALDONADO RD, PHOENIX, AZ 85041-6371
(480) 518-5552
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
247100000X
Radiologic Technologist
—
—
2471C3402X
Radiography Radiologic Technologist
—
—
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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