Individual
ASIA GRISHCHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
940 W MOUNT VERNON ST STE 100, NIXA, MO 65714-9613
(417) 724-5300
Mailing address
940 W MOUNT VERNON ST STE 100, NIXA, MO 65714-9613
(417) 724-5300
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2019005376
MO
Other
Enumeration date
02/15/2019
Last updated
02/15/2019
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