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General NPI Number Information
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NPI Number | 1235806381
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Entity Type | Individual
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Provider Name | CHRISTINE GRIMES BCTMB LMT
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Gender | Female
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 1146 MINOT AVE
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City | AUBURN
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State | ME
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Zip | 04210-3739
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Country | US
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Telephone | 207-333-1140
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Fax |
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Provider Business Mailing Address
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Address Line | 334 JOHNSON RD
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City | AUBURN
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State | ME
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Zip | 04210-8706
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Country | US
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Telephone | 207-333-1140
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MT6898
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License Number State | ME
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