Individual
GRAYSON MATTHEW GREMILLION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5519 CANAL BLVD, NEW ORLEANS, LA 70124-2715
(504) 650-5979
Mailing address
5519 CANAL BLVD, NEW ORLEANS, LA 70124-2715
(504) 650-5979
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2011
Last updated
04/19/2011
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