Individual
AUDRA MICHELLE GROSMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
280 RICHBRIAR ST, MEMPHIS, TN 38120-1858
(901) 682-9974
Mailing address
280 RICHBRIAR ST, MEMPHIS, TN 38120-1858
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0000001641
TN
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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