Individual
JOANN MARY GRINWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
3200 PLEASANT VALLEY RD, WEST BEND, WI 53095-9274
(262) 677-6815
(262) 677-6801
Mailing address
3110 STATE ROAD 83, HARTFORD, WI 53027-9004
(262) 673-3846
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1086-027
WI
Other
Enumeration date
01/10/2007
Last updated
07/08/2007
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