Individual
CHARISSA LEA GRIGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3047 WILLIAM ST, CAPE GIRARDEAU, MO 63703-6393
(573) 339-5989
Mailing address
755 HILLCREST DR, JACKSON, MO 63755-3139
(573) 382-6249
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2014002154
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2014002154
—
MO
Enumeration date
11/24/2021
Last updated
11/24/2021
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