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Individual

JESSICA LYNN GRIMM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
12800 N LAKE SHORE DR, MEQUON, WI 53097
(262) 243-4498
Mailing address
12800 N LAKE SHORE DR, MEQUON, WI 53097-2418
(262) 243-4498

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11311-24
WI

Other

Enumeration date
03/24/2010
Last updated
06/17/2018
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