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NPI 1588108963

NPI 1588108963 : TERI GRIM : GERMANTOWN, TN

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General NPI Number Information
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    NPI Number           |    1588108963
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    Entity Type          |    Individual 
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    Provider Name        |    TERI GRIM
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    12/05/2016
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    Last Update Date     |    12/10/2025
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Provider Practice Location Address
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    Address Line         |    2100 EXETER RD STE 200 
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    City                 |    GERMANTOWN
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    State                |    TN
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    Zip                  |    38138-3966
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    Country              |    US
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    Telephone            |    901-522-6440
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    Fax                  |    901-757-2507
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Provider Business Mailing Address
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    Address Line         |    2100 EXETER RD STE 200 
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    City                 |    GERMANTOWN
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    State                |    TN
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    Zip                  |    38138-3966
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    Country              |    US
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    Telephone            |    901-522-6440
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    Fax                  |    901-757-2507
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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        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    1110138
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    License Number State |    TX
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Taxonomy #2
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    Taxonomy Code        |    225100000X
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    Taxonomy Name        |    Physical Therapist
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    License Number       |    CP051584T
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    License Number State |    TN
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