Individual
MR. ORTON F GRINNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CFA
Contact information
Practice address
230 AUDUBON DR, MANDEVILLE, LA 70471
(985) 845-1501
(985) 845-1601
Mailing address
230 AUDUBON DR, MANDEVILLE, LA 70471
(985) 845-1501
(985) 845-1601
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
F01315
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F01315
N CERT OF FIRST ASSISTANT
LA
Enumeration date
05/25/2007
Last updated
10/14/2008
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