Individual
MR. DAVID KEITH GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
3950 S COUNTRY CLUB RD, SUITE 130, TUCSON, AZ 85714-2099
(520) 874-2048
Mailing address
PO BOX 245052, TUCSON, AZ 85724-5052
(520) 874-2048
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP3412
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
639575
—
AZ
Enumeration date
09/03/2009
Last updated
07/09/2014
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