Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 106903 | MO |
NPI | 1033252945 |
---|---|
Provider Name | Dr. Julia E Griesemer |
First Address | Springfield, MO 65801-2580 |
Second Address | Springfield, MO 65804-2203 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 02/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033252945 | (05) | MO |
126001001 | (05) | AR |
13884 | MO BLUE SHIELD (01) | MO |
81698 | ARK BLUE SHIELD (01) | AR |
F89047 | (02) |