Individual
KEVIN J GROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C-PED
Contact information
Practice address
3330 ASBURY RD, DUBUQUE, IA 52002-2900
(563) 557-1651
(563) 557-0073
Mailing address
3330 ASBURY RD, DUBUQUE, IA 52002-2900
(563) 557-1651
(563) 557-0073
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
NONE
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0264473
—
IA
Enumeration date
10/23/2006
Last updated
07/09/2007
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