Individual
NICOLE GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(800) 872-8662
(608) 372-1724
Mailing address
500 E VETERANS ST, TOMAH, WI 54660-3105
(800) 872-8662
(608) 372-1724
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1550-19
WI
Other
Enumeration date
01/25/2017
Last updated
01/25/2017
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