Healthcare Provider Details

I. General information

NPI: 1285100560
Provider Name (Legal Business Name): ASHLEY BRIANNE GRIME DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 WELLESLEY TRADE LN STE 101
CARY NC
27519-5593
US

IV. Provider business mailing address

150 WELLESLEY TRADE LN STE 101
CARY NC
27519-5593
US

V. Phone/Fax

Practice location:
  • Phone: 984-241-9170
  • Fax:
Mailing address:
  • Phone: 984-241-9170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP24355
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: