Provider Demographics
NPI:1316328388
Name:GRIMM, ALEXANDER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:GRIMM
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 HOPKINS ST APT 3
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45203-1446
Mailing Address - Country:US
Mailing Address - Phone:513-675-1168
Mailing Address - Fax:
Practice Address - Street 1:423 HOPKINS ST APT 3
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45203-1446
Practice Address - Country:US
Practice Address - Phone:513-675-1168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH013828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist