Individual
NEVIN GROSSNICKLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CERTIFIED MASSAGE TH
Contact information
Practice address
319 4TH STREET, LL, WAUSAU, WI 54403
(715) 693-6095
Mailing address
981 WAMBOLD DR, MOSINEE, WI 54455-9583
(715) 693-6095
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
10444-146
WI
Other
Enumeration date
08/05/2014
Last updated
08/07/2014
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