Individual
LAURA MARIE GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
929 JASONWAY AVE, COLUMBUS, OH 43214-4321
(614) 538-2250
(614) 538-2256
Mailing address
929 JASONWAY AVE, COLUMBUS, OH 43214-3201
(614) 538-2250
(614) 538-2256
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003585
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076635
—
OH
Enumeration date
10/01/2012
Last updated
10/19/2020
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