Individual
NATHANIEL VINCENT GRIMM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, LAT, ATC
Contact information
Practice address
19401 CRYSTAL ROCK DR, GERMANTOWN, MD 20874-1593
(585) 645-8640
Mailing address
454 DUNWOODY XING, WEBSTER, NY 14580-9449
(585) 645-8640
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126003499
VA
Other
Enumeration date
11/06/2021
Last updated
07/09/2022
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