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NPI Code Detail

MEDICARE: MRS. AMY LYNN GRILLOT

MEDICARE:  MRS. AMY LYNN GRILLOT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker

General Provider Information

NPI Number : 1205423217
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. AMY LYNN GRILLOT
Provider Business Mailing Address
First Line : 18000 E SHELBY RD
Second Line :
City : NEW KNOXVILLE
State : OH
Zip : 45871-9535
Country : US
Telephone Number : 937-726-4882
Fax Number :
Provider Business Practice Location Address
First Line : 18000 E SHELBY RD
Second Line :
City : NEW KNOXVILLE
State : OH
Zip : 45871-9535
Country : US
Telephone Number : 937-726-4882
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2020
Last Update Date : 12/23/2020

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Directions to “ MRS. AMY LYNN GRILLOT ” Practice Location

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