Lisa Grizzle, COTA

NPI #1700327293 in Los Lunas, New Mexico

Provider Information

NPI Number: 1700327293
Entity Type: Individual
Name: Lisa Grizzle, COTA
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Contractor
Credential: COTA
Enumeration Date: Mar 16, 2017
Last Updated: Mar 16, 2017

Practice Location

Address: 330 EL CERRO MISSION
City: Los Lunas
State: New Mexico
ZIP Code: 87031
Phone: (361) 772-8419

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Contractor	171W00000X	Primary

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