Individual
COURTNEY GRISWOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1930 N BUSINESS ROUTE 5 UNIT 1B, CAMDENTON, MO 65020-2659
(573) 346-7445
Mailing address
16528 300TH RD, UNIONVILLE, MO 63565-3236
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2015036867
MO
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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