Provider Information for 1225195605
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Mr. VICTOR T GRIMES LPC
Sex: Male
NPI: 1225195605
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1225195605 | ||||||||
| Enumeration Date | 2007-01-03 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 6771 GREEN MEADOWS LN MORROW, GA 30260-2834 United States Phone: 404-552-9977 | Fax: | ||||||||
| Primary Practice Address | 3951 SNAPFINGER PKWY DECATUR, GA 30035-3204 United States Phone: 404-552-9977 | Fax: | ||||||||
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