Individual
ELIZABETH J GRIMLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
500 W BROADWAY ST, MISSOULA, MT 59802-4008
(406) 721-5600
(406) 721-3907
Mailing address
PO BOX 7609, MISSOULA, MT 59807-7609
(406) 721-5600
(406) 721-3907
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8595
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
011002823
MEDICARE ID - TYPE UNSPECIFIED
MT
05
—
1124134861
—
MT
Enumeration date
08/23/2006
Last updated
01/11/2016
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