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Individual

BENJAMIN GRIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MSAT, LAT, ATC

Contact information

Practice address
1 LANCER WAY, WINONA LAKE, IN 46590-0001
(260) 450-7939
Mailing address
1673 N VICKY LN, WARSAW, IN 46582-5914

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
IN

Other

Enumeration date
03/23/2026
Last updated
03/23/2026
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