Individual
COLIN R GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, MS, PHD
Contact information
Practice address
6630 UNIVERSITY AVE, REHABILITATION CLINIC - MIDDLETON MAIL CODE 9430, MIDDLETON, WI 53562-3036
(608) 263-8412
Mailing address
1441 CLIFTON RD NE, ATLANTA, GA 30322-1004
(404) 712-8685
Taxonomy
Speciality
Code
Description
License number
State
2251N0400X
Neurology Physical Therapist
Primary
PT017062
GA
225XN1300X
Neurorehabilitation Occupational Therapist
4776-24
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4776-24
PT NEURO REHAB
WI
Enumeration date
07/28/2006
Last updated
07/09/2024
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