Individual
BRIDGET GRIMES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8560 26TH AVE, KENOSHA, WI 53143-6447
(920) 207-7904
Mailing address
8527 N 60TH ST, BROWN DEER, WI 53223-2801
(920) 207-7904
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2166-39
WI
Other
Enumeration date
01/02/2020
Last updated
01/02/2020
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