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1689090920
CARTER LANE GRISSOM
UKIAH, CA
NPI
1689090920
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2014-03-11
Last Update Date
2014-03-11
Business Address
Mr. CARTER LANE GRISSOM
776 SO. STATE ST. SUITE 107
UKIAH, CA 95482
Phone number: 707-463-4915
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Mailing Address
Mr. CARTER LANE GRISSOM
776 SO. STATE ST. SUITE 107
UKIAH, CA 95482
Phone number: 707-463-4915
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