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Individual

JUDITH L GRIMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
1706 STANLEY RD, SUITE 91, FORT SAM HOUSTON, TX 78234-7648
(210) 295-7618
(210) 295-7523
Mailing address
1706 STANLEY RD, SUITE 91, FORT SAM HOUSTON, TX 78234-7648
(210) 295-7618
(210) 295-7523

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
11/04/2008
Last updated
11/04/2008
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