Provider Demographics
NPI:1033372065
Name:GRIMES, AMY D (PT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:D
Last Name:GRIMES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10752 N 89TH PL
Mailing Address - Street 2:SUITE C-134
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6730
Mailing Address - Country:US
Mailing Address - Phone:480-860-4411
Mailing Address - Fax:480-860-2651
Practice Address - Street 1:10752 N 89TH PL
Practice Address - Street 2:SUITE C-134
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6730
Practice Address - Country:US
Practice Address - Phone:480-860-4411
Practice Address - Fax:480-860-2651
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2706225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist