Individual
NICHOLAS ALAN GRONHOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2150 S COUNTRY CLUB DR STE 20, MESA, AZ 85210-6879
(480) 398-4280
(480) 398-4281
Mailing address
PO BOX 50218, PHOENIX, AZ 85076-0218
(602) 918-4318
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
046679
AZ
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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