Individual
JESSICA GROLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
109 S MAIN ST STE D, LYMAN, WY 82937-5177
(307) 787-3278
Mailing address
109 S MAIN ST STE D, LYMAN, WY 82937-5177
(307) 787-3278
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1594
WY
Other
Enumeration date
09/28/2022
Last updated
09/28/2022
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