Individual
SARAH E GRISSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4101 DAYTON BLVD, RED BANK, TN 37415-7156
(423) 499-7710
(423) 499-7711
Mailing address
4101 DAYTON BLVD, RED BANK, TN 37415-7156
(423) 499-7710
(423) 499-7711
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3294
TN
363AM0700X
Medical Physician Assistant
0010-01972
NC
363AM0700X
Medical Physician Assistant
016538
NY
Other
Enumeration date
09/15/2009
Last updated
05/08/2023
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