Individual
GRACE NYS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
483 HARVEST HILL DR, DENMARK, WI 54208-8314
(920) 639-3512
Mailing address
483 HARVEST HILL DR, DENMARK, WI 54208-8314
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
04/23/2025
Last updated
04/23/2025
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