Individual
JACOB GRIME
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
735 S SHOOP AVE, WAUSEON, OH 43567-1735
(419) 335-3242
(419) 335-3222
Mailing address
735 S SHOOP AVE, WAUSEON, OH 43567-1735
(419) 335-3242
(419) 335-3222
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.025835
OH
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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