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Individual

KRISTINE GREVE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 233-0447
(920) 233-1362
Mailing address
845 SOUTH MAIN STREET, SUITE 120, FOND DU LAC, WI 54935
(920) 233-0447
(920) 233-1362

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2316-026
WI
225X00000X
Occupational Therapist
2316026
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
40886100
WI
Enumeration date
05/02/2007
Last updated
02/01/2010
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