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Individual

JEANNE T GROOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500
Mailing address
824 ILLINOIS AVE, STEVENS POINT, WI 54481-3112
(715) 342-7500

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
28881
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
28881
WI STATE LIC
WI
05
31367700
WI
Enumeration date
01/23/2007
Last updated
12/14/2011
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