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General NPI Number Information
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NPI Number | 1972748473
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Entity Type | Individual
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Provider Name | CHRISTY A GRIMES MS ED, ATC, CSCS
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Gender | Female
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 12/11/2008
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Provider Practice Location Address
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Address Line | 8700 NW RIVER PARK DR # 1053
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City | PARKVILLE
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State | MO
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Zip | 64152-4358
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Country | US
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Telephone | 816-584-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 7628 PENNSYLVANIA AVE
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City | KANSAS CITY
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State | MO
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Zip | 64114-1736
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Country | US
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Telephone | 816-444-5055
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2006036872
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2400261
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License Number State | KS
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