DETRIC GRIFFIN

KOSCIUSKO, MS
NPI1487007167
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: MS  5972)
Enumeration Date2016-07-19
Last Update Date2016-07-19
Business Address
DETRIC GRIFFIN
2191 ATTALA ROAD 1006
KOSCIUSKO, MS 39090-6146
Phone number: 662-739-1320
Mailing Address
DETRIC GRIFFIN
2191 ATTALA ROAD 1006
KOSCIUSKO, MS 39090-6146
Phone number: 662-739-1320
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