Provider Demographics
NPI:1801456116
Name:GRIMMER, JOSHUA STEVEN
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:STEVEN
Last Name:GRIMMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3161 BOY SCOUT RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48706-1254
Mailing Address - Country:US
Mailing Address - Phone:989-326-5713
Mailing Address - Fax:
Practice Address - Street 1:500 W GENESEE ST
Practice Address - Street 2:
Practice Address - City:FRANKENMUTH
Practice Address - State:MI
Practice Address - Zip Code:48734-1313
Practice Address - Country:US
Practice Address - Phone:989-652-6101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty