Individual
JODI GRINSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, ATC
Contact information
Practice address
1613 CENTERVILLE RD, FERNDALE, CA 95536-9503
(707) 845-6553
Mailing address
1613 CENTERVILLE RD, FERNDALE, CA 95536-9503
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000023671
CA
Other
Enumeration date
05/29/2016
Last updated
05/29/2016
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