Individual
JONATHAN JAMES GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 POLE LINE RD W, TWIN FALLS, ID 83301-5810
(208) 814-2500
Mailing address
844 BIGHORN DR, TWIN FALLS, ID 83301-4088
(208) 313-4676
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7338
ID
Other
Enumeration date
12/27/2019
Last updated
12/27/2019
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