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1184383440
ADAM GRISHAM
WASILLA, AK
NPI
1184383440
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-12-14
Last Update Date
2021-12-14
Business Address
ADAM GRISHAM
7010 E BOGARD RD BLDG 1
WASILLA, AK 99654-4711
Phone number: 907-373-4732
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Mailing Address
ADAM GRISHAM
PO BOX 876741
WASILLA, AK 99687-6741
Phone number: 907-373-4732
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