NPI 1235946864

Marcus S Grimsley

Practitioner Independent Duty Corpsman Venice, LA

Practice location

Address: 436 Coast Guard Rd, Venice, LA 70091-4340
Phone: (504) 915-7195

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X

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Registry record

NPI: 1235946864
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Dec 2024
Record last updated: 17 Dec 2024

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.