Individual
KRISTOPHER GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
321 E MILWAUKEE ST, JANESVILLE, WI 53545-3015
(608) 554-0894
Mailing address
PO BOX 7, EDGERTON, WI 53534-0007
(608) 286-0304
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
13928
WI
Other
Enumeration date
07/12/2022
Last updated
09/09/2022
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