Matthew G Grissom

NPI #1588357420 in Park Hill, Oklahoma

Provider Information

NPI Number: 1588357420
Entity Type: Individual
Name: Matthew G Grissom
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Peer Specialist
Enumeration Date: May 26, 2023
Last Updated: Aug 31, 2023

Practice Location

Address: 28232 S 547 RD
City: Park Hill
State: Oklahoma
ZIP Code: 74451-2866
Phone: (239) 900-4326

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Peer Specialist	175T00000X	Primary

Additional Practice Locations

28232 S 547 Rd

Park Hill, OK, 74451-2866

(239) 900-4326

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