Individual
GRANT CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 ASHLEY HILLS DR, LEXINGTON, SC 29072-7906
(803) 351-3938
Mailing address
101 ASHLEY HILLS DR, LEXINGTON, SC 29072-7906
(803) 351-3938
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5509
SC
363A00000X
Physician Assistant
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/31/2024
Last updated
01/02/2026
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