| NPI | 1629177357 |
|---|---|
| Former Name | JENNIPHER LYN GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004458B) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 1797DT) |
| 152W00000X Optometrist (Licence: OH 6176) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2024-01-19 |