CARTER LANE GRISSOM

UKIAH, CA
NPI1689090920
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Enumeration Date2014-03-11
Last Update Date2014-03-11
Business Address
MR. CARTER LANE GRISSOM
776 SO. STATE ST. SUITE 107
UKIAH, CA 95482
Phone number: 707-463-4915
Mailing Address
MR. CARTER LANE GRISSOM
776 SO. STATE ST. SUITE 107
UKIAH, CA 95482
Phone number: 707-463-4915
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