Individual
KENNETH GRIMM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
6000 W CREEK RD, INDEPENDENCE, OH 44131-2139
(216) 986-1314
(216) 986-1191
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
34005924G
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115208
—
OH
Enumeration date
04/19/2006
Last updated
03/12/2009
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