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1619032380
MARK RAYMOND GRUESBECK
SAN FRANCISCO, CA
NPI
1619032380
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AZ 0660)
Enumeration Date
2006-12-23
Last Update Date
2007-07-08
Business Address
MARK RAYMOND GRUESBECK ATC
24 WILLIE MAYS PLZ
SAN FRANCISCO, CA 94107-2134
Phone number: 415-972-1633
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Mailing Address
MARK RAYMOND GRUESBECK ATC
8829 E FAIRBROOK ST
MESA, AZ 85207-5117
Phone number: 480-986-4620
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