Organization
KELLY GRIM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY R GRIM (PROVIDER)
(775) 287-6029
Entity
Organization
Contact information
Practice address
2277 SUNRISE DR, RENO, NV 89509-3751
(775) 287-6029
Mailing address
2277 SUNRISE DR, RENO, NV 89509-3751
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9005041213
—
NV
Enumeration date
03/24/2016
Last updated
03/24/2016
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