Provider Demographics
NPI:1447040183
Name:GRICE, ADDISON
Entity type:Individual
Prefix:
First Name:ADDISON
Middle Name:
Last Name:GRICE
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 CAMBER LN APT 7206
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-0320
Mailing Address - Country:US
Mailing Address - Phone:706-831-0563
Mailing Address - Fax:
Practice Address - Street 1:7100 CAMBER LN APT 7206
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-0320
Practice Address - Country:US
Practice Address - Phone:706-831-0563
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant