Individual
ROGER D GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3813 S. MADISON ST., MUNCIE, IN 47302
(765) 751-3362
Mailing address
1470 E. STATE ST., ALBANY, IN 47320
(765) 789-6178
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000488A
IN
Other
Enumeration date
06/29/2006
Last updated
07/08/2007
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