Kim M Grisar, PTA

NPI #1912947391 in Port Washington, Wisconsin

Provider Information

NPI Number: 1912947391
Entity Type: Individual
Name: Kim M Grisar, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Jun 7, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1317 W GRAND AVE
City: Port Washington
State: Wisconsin
ZIP Code: 53074-2075
Phone: (262) 284-2261

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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