Individual
MRS. JENNIFER L VOLLRATH-GROSAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS, DC, FICPA
Contact information
Practice address
721 CARDINAL LN, STE 100, GREEN BAY, WI 54313-3216
(920) 434-2221
(920) 434-2483
Mailing address
PO BOX 11067, GREEN BAY, WI 54307-1067
(920) 434-2221
(920) 434-2483
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38897900
—
WI
Enumeration date
10/16/2006
Last updated
07/08/2007
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