Doctor Name: | CHELSEA GRIMSTAD |
NPI Number: | 1184098444 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 102629 |
Business Practice Address: | 1914 Mill Bay Rd Kodiak, AK - 996156631 |
Business Phone Number: | 9074865418 |
Business Fax Number: | |
Mailing Address: | 1914 Mill Bay Rd, KODIAK |
State: | AK |
Postal Code: | 996156631 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 11/23/2015 |
NPI Last Update Date: | 11/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174M00000X |
License Number: | 102629 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Veterinarian |
Taxonomy Specialization: | |
Taxonomy Definition: | A doctor of veterinary medicine, trained and authorized to practice veterinarian medicine and surgery. |