Most Relevant Information
Provider Data
| NPI Number: | 1003473562 |
| Provider Name: | EVAN GRISKOWITZ MS, ATC, LAT |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | AT1455 |
Most Important Dates
| Enumeration Date: | 05/21/2019 |
| Last Updated: | 05/21/2019 |
Provider Practice Location
3802 LADY DI LN
LEXINGTON
KY
405171021
Practice Location Phone/Fax
| Phone: | 3025406145 |
| Fax: |
Provider Mailing Location
3802 LADY DI LN
LEXINGTON
KY
405171021
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |