Individual
DEANNE R GRIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
4089 WEBSTER ROAD, SUMMERSVILLE, WV 26651
(304) 872-0111
Mailing address
330 NELSON AVENUE, SUMMERSVILLE, WV 26651-1743
(304) 619-1018
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01180
WV
Other
Enumeration date
06/09/2006
Last updated
12/21/2021
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