Individual
EDGAR GROTEFEND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
721 S HIGHWAY 78, WYLIE, TX 75098-4004
(972) 303-8100
Mailing address
930 E 15TH ST APT 318, PLANO, TX 75074-5845
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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