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Individual

DARRELL GRENNOCK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
13548 232ND ST, LAURELTON, NY 11413-2536
(718) 506-8221
Mailing address
13548 232ND ST, LAURELTON, NY 11413-2536
(718) 506-8221

Taxonomy

Speciality
Code
Description
License number
State
372500000X
Chore Provider
Primary
291286-1
NY

Other

Enumeration date
05/07/2015
Last updated
05/07/2015
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