Individual
LISA GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2812 ALBERTI DR, FLORENCE, SC 29501-5333
(843) 621-2101
(843) 317-9944
Mailing address
2812 ALBERTI DR, FLORENCE, SC 29501-5333
(843) 621-2101
(843) 317-9944
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
804
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH0390
—
SC
Enumeration date
01/08/2007
Last updated
07/09/2007
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