Individual
MARK GRIMMETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2145 E WARNER RD STE 104, TEMPE, AZ 85284-3549
(480) 664-9443
(480) 664-9378
Mailing address
1839 S ALMA SCHOOL RD STE 354, MESA, AZ 85210-3028
(480) 726-2287
(888) 316-9272
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
7034950001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7045160001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7046960001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7047150001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7057360001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7209350001
AZ
332B00000X
Durable Medical Equipment & Medical Supplies
7629170001
AZ
363AM0700X
Medical Physician Assistant
Primary
6657
AZ
Other
Enumeration date
11/09/2005
Last updated
03/20/2018
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