Charles J Grim, D.C.
Individual provider Active NPI Chiropractor · Holmes, PA
NPI 1114035490 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114035490
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC002444L (PA)
- Practice address
- 1924 Parker Ave
Holmes, PA 19043-1414 - Phone
- (610) 237-6645
- Fax
- (610) 237-6473
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC002444L | PA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Therapy Physicians PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | DC002444L | PA | Yes |
Addresses
Primary practice location
1924 Parker Ave
Holmes, PA 19043-1414
Mailing address
1924 Parker Ave
Holmes, PA 19043-1414
Phone (610) 237-6645
Other providers in Holmes, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.