| Organization Name: | RECTAL RELIEF CENTER |
| NPI Number: | 1215190459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHERI SHANNON GRISSO (PRESIDENT) |
| Mailing Address: | 13005 Southern Blvd Ste 122 Suite 122 Medical Mall One Loxahatchee |
| State: | FL US |
| Postal Code: | 334709231 |
| Phone Number: | 5618425050 |
| Fax Number: | 5617939989 |
| NPI Enumeration Date: | 07/08/2008 |
| NPI Last Update Date: | 11/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | ARNP3357122 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |