Individual
GRACE MODGLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2927 S FISH HATCHERY RD, FITCHBURG, WI 53711-6498
(608) 819-6394
Mailing address
W347S10163 UPPER CLARKS PARK RD, EAGLE, WI 53119-1852
(262) 853-3346
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
07/25/2022
Last updated
07/25/2022
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