Individual
KENNETH J GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50439 INDEPENDENCE ST, CANTON, MI 48188-6735
(734) 879-1068
Mailing address
49796 TAFT LN, CANTON, MI 48188-6722
(734) 446-0310
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301064321
MI
Other
Enumeration date
01/10/2006
Last updated
01/06/2012
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