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Individual

DANIEL L GRIPSHOVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CP

Contact information

Practice address
503 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3444
(859) 426-7800
Mailing address
PO BOX 17277, COVINGTON, KY 41017-0277
(859) 426-7800

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1153
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000249594
ANTHEM
KY
01
1199659
CHA
KY
01
294319000
MAGELLAN
KY
01
680015873
MEDICARE RAILROAD
KY
05
89000640
KY
01
CK6701
RAILROAD MEDICARE
KY
Enumeration date
11/19/2005
Last updated
05/19/2008
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