Individual
JILL GRIMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1226 HARVESTER CIR, MYRTLE BEACH, SC 29579-3292
(336) 465-6527
Mailing address
1226 HARVESTER CIR, MYRTLE BEACH, SC 29579-3292
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1118
SC
Other
Enumeration date
06/15/2012
Last updated
06/15/2012
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