Individual
WILLIAM GRIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1365A CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-3381
Mailing address
1365A CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-3381
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
019688
GA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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