Individual
LAKEN R GRIMALDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
306 THELMA ST, LONGVIEW, TX 75604-3974
(903) 399-9144
Mailing address
306 THELMA ST, LONGVIEW, TX 75604-3974
(903) 399-9144
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
305036
TX
Other
Enumeration date
03/29/2018
Last updated
03/29/2018
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