Individual
AMANDA GROSNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CD, RD
Contact information
Practice address
1172 N 4TH ST, WATERTOWN, WI 53098-3202
(920) 253-9138
Mailing address
1172 N 4TH ST, WATERTOWN, WI 53098-3202
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86198614
WI
Other
Enumeration date
09/10/2024
Last updated
09/10/2024
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