Individual
RETIA GRISSETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3913 WESTMORE DR, COLUMBIA, SC 29223-4769
(803) 446-7480
Mailing address
4711 FOREST DR, STE 3 PMB 157, COLUMBIA, SC 29206-3125
(803) 232-9066
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
008334577
SC
347C00000X
Private Vehicle
371446270
SC
347C00000X
Private Vehicle
—
SC
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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