Individual
AUTUMN GRANSBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
15720 W NATIONAL AVE, NEW BERLIN, WI 53151-5119
(262) 785-5515
Mailing address
4024 N 98TH ST, MILWAUKEE, WI 53222-1421
(414) 336-0683
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11942-146
WI
Other
Enumeration date
02/02/2013
Last updated
02/02/2013
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