Individual
JESSIE KAE GROTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2525 WASHINGTON ST, PELLA, IA 50219-1553
(641) 628-6728
(641) 628-6727
Mailing address
405 MONROE ST, PELLA, IA 50219-1189
(641) 621-2347
(641) 628-7241
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115509
IOWA PROVIDER LICENSE
IA
Enumeration date
07/20/2022
Last updated
07/20/2022
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