Individual
LISA A.W. GRIFFIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1055 N 500 W, SUITE 222, PROVO, UT 84604-3305
(801) 377-4623
(801) 429-8150
Mailing address
1055 N 500 W, CREDENTIALING DEPARTMENT, PROVO, UT 84604-3305
(801) 354-8225
(801) 429-8150
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4737816-1206
UT
Other
Enumeration date
05/15/2007
Last updated
08/14/2008
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