Lucas Grim

NPI #1083014732 in Alliance, Ohio

Provider Information

NPI Number: 1083014732
Entity Type: Individual
Name: Lucas Grim
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Aug 31, 2014
Last Updated: Aug 31, 2014

Practice Location

Address: 1972 CLARK AVE
Address 2: BOX #664
City: Alliance
State: Ohio
ZIP Code: 44601-3929
Phone: (724) 730-4336

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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