Individual
REAGAN GRIMMETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
506 HOLLY AVENUE, LOGAN, WV 25601
(304) 792-2060
Mailing address
PO BOX 266, BRUNO, WV 25611-0266
(304) 688-5754
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
116579
WV
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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