Individual
GUILHERME DE OLIVEIRA GRIZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
603 KINGWOOD ST UNIT B, EASTON, PA 18045-5208
(914) 291-6727
Mailing address
603 KINGWOOD ST UNIT B, EASTON, PA 18045-5208
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NA
—
PA
Enumeration date
02/02/2022
Last updated
02/02/2022
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