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1699819730
SHASTA VICTORIA GRIMES CASTRO-PENULLAR
JERSEY CITY, NJ
NPI
1699819730
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Other Name
SHASTA VICTORIA GRIMES CASTRO
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: NJ 40PTQA0833700)
Enumeration Date
2007-02-19
Last Update Date
2007-12-10
Business Address
Mrs. SHASTA VICTORIA GRIMES CASTRO-PENULLAR BSPT
242 10TH ST
JERSEY CITY, NJ 07302-1406
Phone number: 201-795-2499
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Mailing Address
Mrs. SHASTA VICTORIA GRIMES CASTRO-PENULLAR BSPT
257 BOYD AVE
JERSEY CITY, NJ 07304-1103
Phone number: 201-200-0650
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