Individual
MS. TRACY GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1110 WILLIAMS ST, LAKE GENEVA, WI 53147-1254
(262) 949-4965
Mailing address
1110 WILLIAMS ST, LAKE GENEVA, WI 53147-1254
(262) 949-4965
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
655-146
WI
Other
Enumeration date
01/15/2024
Last updated
01/15/2024
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