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1104279660
KATHLEEN GRINVALSKY
PORTLAND, ME
NPI
1104279660
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: ME AT616)
Enumeration Date
2016-07-20
Last Update Date
2016-07-20
Business Address
KATHLEEN GRINVALSKY ATC
1265 WASHINGTON AVE
PORTLAND, ME 04103-3644
Phone number: 207-318-8788
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Mailing Address
KATHLEEN GRINVALSKY ATC
1265 WASHINGTON AVE
PORTLAND, ME 04103-3644
Phone number: 207-318-8788
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