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1245892645
JACQUELINE AGNES GRIMM
GALLUP, NM
NPI
1245892645
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: KY 2145DT)
Enumeration Date
2019-07-05
Last Update Date
2019-07-05
Business Address
Dr. JACQUELINE AGNES GRIMM OD
516 E NIZHONI BLVD
GALLUP, NM 87301-5748
Phone number: 505-722-1000
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Mailing Address
Dr. JACQUELINE AGNES GRIMM OD
2240 BONHAVEN RD
LEXINGTON, KY 40515-1150
Phone number: 859-421-3369
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