Individual
GABRIELLE LECHEMINANT GRIMMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
590 S WAKARA WAY, SALT LAKE CITY, UT 84108-1200
(801) 587-7109
Mailing address
252 W LARIAT BLVD, SARATOGA SPRINGS, UT 84045-3138
(801) 592-7449
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11477475-1206
UT
363AS0400X
Surgical Physician Assistant
Primary
11477475-1206
UT
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
10/15/2019
Last updated
11/02/2021
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