Individual
JADE RENE GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
126 PAVILION PKWY, FAYETTEVILLE, GA 30214-4056
(770) 954-8988
(404) 393-2447
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT008151
GA
Other
Enumeration date
08/24/2021
Last updated
01/12/2022
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