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Organization

BOLSTER WELLNESS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JUSTIN LEE GROSE PMHNP-BC (OWNER)
(812) 408-3265
Entity
Organization

Contact information

Practice address
928 SYCAMORE ST, ROCKPORT, IN 47635-9283
(812) 408-3265
(812) 780-2730
Mailing address
221 MAIN ST, GRANDVIEW, IN 47615-9469
(812) 408-3265
(812) 780-2730

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary

Other

Enumeration date
04/24/2025
Last updated
05/30/2025
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