Individual
ARIANNE GRAVUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
202 S PARK ST, MADISON, WI 53715-1507
(608) 417-8250
Mailing address
1 S PARK ST, MADISON, WI 53715-1375
(608) 417-8250
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
10738-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36127800
—
WI
Enumeration date
03/01/2007
Last updated
08/23/2012
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