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Individual

MS. JACQUELINE A GROCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR

Contact information

Practice address
2155 W PARK CT, SUITE G, STONE MOUNTAIN, GA 30087-3500
(770) 465-5084
(770) 465-5304
Mailing address
1528 BRETON HUNT LN, SUWANEE, GA 30024-3874
(678) 482-6040

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT003908
GA

Other

Enumeration date
04/06/2007
Last updated
07/08/2007
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