Individual
JULIE DIANA GRONBOLDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14201 BROAD OAKS CT, MIDLOTHIAN, VA 23112-4618
(804) 312-6154
Mailing address
14201 BROAD OAKS CT, MIDLOTHIAN, VA 23112-4618
(804) 312-6154
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119000010
VA
Other
Enumeration date
08/31/2020
Last updated
08/31/2020
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