Individual
DERRICK GRIESHABER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 8TH ST S, MOORHEAD, MN 56562-0001
(573) 880-1536
Mailing address
3420 18TH ST S APT 303, MOORHEAD, MN 56560-7116
(573) 880-1536
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2875
MN
Other
Enumeration date
03/27/2018
Last updated
03/27/2018
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