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Individual
TAYLORE MARIE GRIMM
Active
Individual
TAYLORE MARIE GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
3397
TN
363AS0400X
Surgical Physician Assistant
Primary
3397
TN
Other
Enumeration date
10/23/2017
Last updated
06/16/2018
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