Individual
JASON FAIRLEY GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2290 KERFIELD CT, FAYETTEVILLE, NC 28306-2593
(910) 322-3437
Mailing address
2290 KERFIELD CT, FAYETTEVILLE, NC 28306-2593
(910) 322-3437
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6361
NC
Other
Enumeration date
01/03/2022
Last updated
01/03/2022
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