Individual
BROCK JOSEPH GRENIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OT
Contact information
Practice address
725 S WEBSTER AVE, GREEN BAY, WI 54301-3500
(920) 433-3655
(920) 433-3539
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7222
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7184
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7184-26
PROFESSIONAL LICENSE
WI
Enumeration date
02/17/2022
Last updated
02/21/2022
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