Organization
PROLO & INTEGRATED MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER GROTE D.O. (PROVIDER)
(973) 362-5227
Entity
Organization
Contact information
Practice address
532 LAFAYETTE RD, SPARTA, NJ 07871-4411
(973) 362-5227
(973) 250-0045
Mailing address
PO BOX 297, BLAIRSTOWN, NJ 07825-0297
(973) 362-5227
(973) 250-0045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MB03954800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0341401
—
NJ
Enumeration date
09/28/2012
Last updated
09/28/2012
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