Individual
MRS. REGINA LYNN GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, C/NDT, ATP
Contact information
Practice address
205 COUNTY ROAD 441, HOUSTON, MS 38851-7642
(662) 231-1187
(662) 448-1189
Mailing address
205 COUNTY ROAD 441, HOUSTON, MS 38851-7642
(662) 231-1187
(662) 448-1189
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT2444
MS
2251P0200X
Pediatric Physical Therapist
PT2444
MS
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
Primary
74539
MS
Other
Enumeration date
07/26/2006
Last updated
02/10/2020
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