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Individual

JENNIFER RENEE GRUTZIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
2908 MALL RD, FLORENCE, AL 35630-1641
(256) 767-2702
(256) 718-6047
Mailing address
2908 MALL RD, FLORENCE, AL 35630-1641
(256) 767-2702
(256) 718-6047

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.459
AL
363A00000X
Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
107569
AL
01
PA.459
MEDICAL LICENSE
AL
Enumeration date
05/25/2006
Last updated
06/19/2023
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