Individual
MRS. STACY LYNN GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
3461 SAINT MARYS RD, WEST TERRE HAUTE, IN 47885-9683
(812) 917-5618
(812) 917-5618
Mailing address
3461 SAINT MARYS RD, WEST TERRE HAUTE, IN 47885-9683
(812) 917-5618
(812) 917-5618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06004465A
IN
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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