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1427184019
MAURISE GENE VANDERGRIFF
CLEVELAND, TN
NPI
1427184019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
(Licence: TN DPO 319)
Enumeration Date
2007-02-26
Last Update Date
2008-03-06
Business Address
Mr. MAURISE GENE VANDERGRIFF L.D.O.
2415 CHAMBLISS AVE NW
CLEVELAND, TN 37311-3882
Phone number: 423-479-4397
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Mailing Address
Mr. MAURISE GENE VANDERGRIFF L.D.O.
2415 CHAMBLISS AVE NW
CLEVELAND, TN 37311-3882
Phone number: 423-479-4397
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