Most Relevant Information
Provider Data
| NPI Number: | 1003016650 |
| Provider Name: | BONNIE J GRISSOM RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WD0400X |
| Specialty: | Registered Nurse |
| License Number: | 64034 |
Most Important Dates
| Enumeration Date: | 07/23/2007 |
| Last Updated: | 07/23/2007 |
Provider Practice Location
PALMETTO HEALTH BAPTIST DIABETES EDUCATION
1333 TAYLOR STREET; SUITE 4-E
COLUMBIA
SC
29201
Practice Location Phone/Fax
| Phone: | 8032963956 |
| Fax: | 8032968908 |
Provider Mailing Location
PALMETTO HEALTH BAPTIST DIABETES EDUCATION
1333 TAYLOR STREET; SUITE 4-E
COLUMBIA
SC
29201
Provider Mailing Phone/Fax
| Phone: | 8032963956 |
| Fax: | 8032968908 |