Individual
DR. KEITH MICHAEL GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
340 DAWSON ST, PHILADELPHIA, PA 19128-3701
(425) 623-2904
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC006368
PA
Other
Enumeration date
06/29/2012
Last updated
06/29/2012
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