Individual
MARC GROSSNICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1414 N COURT ST, CIRCLEVILLE, OH 43113-1005
(740) 474-9318
Mailing address
359 WALNUT CREEK PIKE, CIRCLEVILLE, OH 43113-1051
(740) 601-3678
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA009927
OH
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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