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Individual

ASHLEY R GRIMMETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PAC

Contact information

Practice address
300 CORPORATE CENTER DRIVE, SCOTT DEPOT, WV 25560
(304) 691-6800
(304) 691-6751
Mailing address
1448 10TH AVE STE 304, HUNTINGTON, WV 25701-3579
(304) 529-0900

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
01210
WV
207NS0135X
Procedural Dermatology Physician
01210
WV
363A00000X
Physician Assistant
Primary
01210
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001898831
BCBS
WV
Enumeration date
10/13/2006
Last updated
02/24/2023
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