Individual
MR. ANTOINE LAMONT GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, CCM
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 445-4674
(757) 444-8541
Mailing address
961 OLMSTEAD ST, CHESAPEAKE, VA 23323-1463
(757) 319-7601
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
0001157257
VA
Other
Enumeration date
10/18/2024
Last updated
10/18/2024
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