Individual
BECKY SUZETTE GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 E 13TH ST, MERCED, CA 95341-6211
(209) 381-6800
Mailing address
301 E 13TH ST, MERCED, CA 95341-6211
(209) 381-6800
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
252695
CA
Other
Enumeration date
03/26/2019
Last updated
03/26/2019
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