Individual
MICHAEL D GRISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, EST
Contact information
Practice address
1202 SKYLINE DR, HOPKINSVILLE, KY 42240-4937
(270) 881-1005
Mailing address
4044 FORT CAMPBELL BLVD, PMB 124, HOPKINSVILLE, KY 42240-4950
(270) 305-1817
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
KY0195
KY
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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