Provider Demographics
NPI:1306037072
Name:GRIMM, KIMBERLY A (OTR/L)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:A
Last Name:GRIMM
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:SETSER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:304 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-4201
Mailing Address - Country:US
Mailing Address - Phone:563-242-5316
Mailing Address - Fax:563-242-3128
Practice Address - Street 1:2320 N 2ND ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-2434
Practice Address - Country:US
Practice Address - Phone:563-243-2285
Practice Address - Fax:563-243-2293
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2013-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL056003555225X00000X
IA00635225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist