Individual
MR. JACK L GRIMM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2221 GRUBE ST, SPRINGFIELD, OH 45503-2642
(937) 399-8941
(937) 399-5639
Mailing address
2221 GRUBE ST, SPRINGFIELD, OH 45503-2642
(937) 399-8941
(937) 399-5639
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9554
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31 110415400
BWC
OH
Enumeration date
12/07/2005
Last updated
04/19/2026
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