Individual
TAMMY GRIM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
HAIR LOSS PRACTIONER
Contact information
Practice address
209 W 2ND ST STE 110, WASHINGTON, MO 63090-2147
(636) 286-6717
(636) 286-6717
Mailing address
209 W 2ND ST STE 110, WASHINGTON, MO 63090-2147
(636) 286-6717
(636) 286-6717
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
090550
MO
Other
Enumeration date
06/15/2026
Last updated
06/15/2026
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