Individual
JUSTIN GREVENGOED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
915 PIERCE ST, SIOUX CITY, IA 51101-1031
(712) 234-8760
Mailing address
1394 2ND AVE SW, LE MARS, IA 51031-2712
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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