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General NPI Number Information
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NPI Number | 1235111634
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Entity Type | Individual
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Provider Name | DANIEL L GRIPSHOVER CP
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Gender | Male
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Dates
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Enumeration Date | 11/19/2005
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Last Update Date | 05/19/2008
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Provider Practice Location Address
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Address Line | 503 CENTRE VIEW BLVD
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City | CRESTVIEW HILLS
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State | KY
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Zip | 41017-3444
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Country | US
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Telephone | 859-426-7800
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17277
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City | COVINGTON
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State | KY
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Zip | 41017-0277
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Country | US
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Telephone | 859-426-7800
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | 1153
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License Number State | KY
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