Individual
DURVELLE GRISSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13708 HARVARD AVE, CLEVELAND, OH 44105-4742
(216) 491-2888
Mailing address
13708 HARVARD AVE, CLEVELAND, OH 44105-4742
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.154892-M-IV
OH
Other
Enumeration date
04/16/2014
Last updated
04/16/2014
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