Individual
ALYSSA D GRISHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 939-4577
(803) 794-4317
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
(803) 791-2350
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
3112
SC
363AM0700X
Medical Physician Assistant
Primary
3112
SC
Other
Enumeration date
10/18/2017
Last updated
04/20/2023
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