Provider Demographics
NPI:1336273382
Name:GRISSMER, JANE (M AC)
Entity type:Individual
Prefix:MS
First Name:JANE
Middle Name:
Last Name:GRISSMER
Suffix:
Gender:F
Credentials:M AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 GEORGIA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3614
Mailing Address - Country:US
Mailing Address - Phone:301-565-4924
Mailing Address - Fax:301-565-4927
Practice Address - Street 1:8720 GEORGIA AVE STE 300
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3614
Practice Address - Country:US
Practice Address - Phone:301-565-4924
Practice Address - Fax:310-565-4927
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00126171100000X
MDUOO126171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist