| NPI | 1295282184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE GRIMES Member 346-228-0614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2016-09-08 |