Organization
HEALTHY U ACADEMY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL G GRIMES MD (MD/OWNER)
(330) 607-0529
Entity
Organization
Contact information
Practice address
1226 MARKET AVE N, CANTON, OH 44714-2604
(330) 607-0529
Mailing address
6384 HOLLYRIDGE ST NW, NORTH CANTON, OH 44720-9402
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35077014G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2256311
—
OH
01
—
GR4052321
MEDICAID ID TYPE UNSPECIFIED
OH
Enumeration date
07/26/2017
Last updated
06/16/2018
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