Individual
MR. JASON KEITH GRIMES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MPT, ATC
Contact information
Practice address
27 SIEMON COMPANY DR, WATERTOWN, CT 06795-2654
(860) 274-7573
(860) 274-5698
Mailing address
102 BLAMEY CIR, STRATFORD, CT 06614-3212
(203) 377-3064
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
007488
CT
Other
Enumeration date
12/05/2005
Last updated
07/08/2007
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