Provider Demographics
NPI:1386687887
Name:GRIMM, HILLARY SAMPSON (MSPT)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:SAMPSON
Last Name:GRIMM
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:HILLARY
Other - Middle Name:
Other - Last Name:SAMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:4031 W PLANO PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5619
Mailing Address - Country:US
Mailing Address - Phone:972-596-1715
Mailing Address - Fax:972-867-9726
Practice Address - Street 1:4031 W PLANO PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5619
Practice Address - Country:US
Practice Address - Phone:972-596-1715
Practice Address - Fax:972-867-9726
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist