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1386695542
TIMOTHY J GRISSOM
FORT WAYNE, IN
NPI
1386695542
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2085R0202X Radiology, Diagnostic Radiology
(Licence: IN 01050244)
Enumeration Date
2006-05-13
Last Update Date
2007-07-08
Business Address
Dr. TIMOTHY J GRISSOM M.D.
2200 RANDALLIA DR
FORT WAYNE, IN 46805-4638
Phone number: 260-373-4731
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Mailing Address
Dr. TIMOTHY J GRISSOM M.D.
3707 NEW VISION DR
FORT WAYNE, IN 46845-1702
Phone number: 260-471-9466
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