Individual
LISA NICOLE GRIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
2233 WISCONSIN AVE NW STE 217, WASHINGTON, DC 20007-4140
(202) 333-5252
(202) 333-1159
Mailing address
1565 N COLONIAL TER APT 403, ARLINGTON, VA 22209-1425
(202) 246-0428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT872119
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT872119
PT LICENSE NUMBER
DC
Enumeration date
08/09/2017
Last updated
08/09/2017
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