Provider Demographics
NPI:1649576216
Name:GRINDOL, TESS
Entity type:Individual
Prefix:
First Name:TESS
Middle Name:
Last Name:GRINDOL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2125 SW POTOMAC DRIVE
Mailing Address - Street 2:APT. 3
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66611-0000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2125 SW POTOMAC DR
Practice Address - Street 2:APARTMENT 3
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66611-1471
Practice Address - Country:US
Practice Address - Phone:785-213-5738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-31
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker