Provider Demographics
NPI:1407255029
Name:GRIMES, REBECCA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:
Last Name:GRIMES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:REETZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4545 GREENLAWN DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-5447
Mailing Address - Country:US
Mailing Address - Phone:330-310-5876
Mailing Address - Fax:
Practice Address - Street 1:4545 GREENLAWN DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-5447
Practice Address - Country:US
Practice Address - Phone:330-310-5876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-19
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH012807225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist