Individual
MARISSA LYNN GROSECLOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 12TH STREET EXT, PRINCETON, WV 24740-2398
(304) 425-9541
Mailing address
2610 CLIFFMONT AVE, BLUEFIELD, WV 24701-5016
(304) 425-9541
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
40699
WV
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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