Individual
WYATT GRABOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
280 N RANDALL RD, LAKE IN THE HILLS, IL 60156-5903
(847) 854-8219
Mailing address
249 WILD MEADOW LN, WOODSTOCK, IL 60098-7624
(815) 236-7120
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
160010235
IL
Other
Enumeration date
12/18/2024
Last updated
12/18/2024
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