JACQUELINE AGNES GRIMM

GALLUP, NM
NPI1245892645
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy152W00000X Optometrist
(Licence: KY  2145DT)
Enumeration Date2019-07-05
Last Update Date2019-07-05
Business Address
Dr. JACQUELINE AGNES GRIMM OD
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
Mailing Address
Dr. JACQUELINE AGNES GRIMM OD
2240 BONHAVEN RD
LEXINGTON, KY 40515-1150
Phone number: 859-421-3369