Individual
ALONZO GERRARD GROGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, AT
Contact information
Practice address
13800 FORD RD, DEARBORN, MI 48126-3296
(313) 308-7195
Mailing address
20434 KLINGER ST, DETROIT, MI 48234-1746
(313) 308-7195
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2601001380
MI
Other
Enumeration date
07/15/2019
Last updated
07/15/2019
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