Individual
KATHLEEN GRINVALSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1265 WASHINGTON AVE, PORTLAND, ME 04103-3644
(207) 318-8788
Mailing address
1265 WASHINGTON AVE, PORTLAND, ME 04103-3644
(207) 318-8788
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT616
ME
Other
Enumeration date
07/20/2016
Last updated
07/20/2016
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