Individual
MR. NEIL B GRAGG, JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
519 MIDLAND CT, SUITE #102, JANESVILLE, WI 53546-2336
(608) 756-9090
(608) 756-2920
Mailing address
519 MIDLAND CT, SUITE #102, JANESVILLE, WI 53546-2336
(608) 756-9090
(608) 756-2920
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
809-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
39543800
—
WI
Enumeration date
06/10/2006
Last updated
07/09/2007
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