Individual
SAMANTHA JO GRONSETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
911 3RD ST W, ASHLAND, WI 54806-1311
(715) 682-8172
Mailing address
911 3RD ST W, ASHLAND, WI 54806-1311
(715) 682-8172
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1667-019
WI
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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