NPI 1023553815

Tedrick Grayson

Practitioner Independent Duty Corpsman West Monroe, LA

Practice location

Address: 152 Toston Rd, West Monroe, LA 71292-2235
Phone: (907) 231-1416

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1023553815
Entity type: Individual
Sex (as registered): Male
NPI issued: 3 Jan 2017
Record last updated: 3 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.