Individual
KELLY GRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2277 SUNRISE DR, RENO, NV 89509-3751
(775) 287-6029
Mailing address
2277 SUNRISE DR, RENO, NV 89509-3751
(775) 287-6029
Taxonomy
Speciality
Code
Description
License number
State
385H00000X
Respite Care
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49194300001
—
NV
Enumeration date
02/29/2016
Last updated
02/29/2016
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