Individual
SETH M GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
555 W STATE ROAD 164, SALEM, UT 84653-5732
(801) 465-4896
Mailing address
1055 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604-3305
(801) 354-8225
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
08/14/2017
Last updated
05/03/2022
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