Individual
JONATHAN GRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4335 FORT HENRY DR, KINGSPORT, TN 37663-2268
(423) 239-6261
Mailing address
4335 FORT HENRY DR, KINGSPORT, TN 37663-2268
(423) 239-6261
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
22278
TN
Other
Enumeration date
02/03/2014
Last updated
02/03/2014
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