Individual
KIMBERLY GROGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 OAK AVE APT 401, EVANSTON, IL 60201-4269
(262) 751-4445
(262) 751-4445
Mailing address
N68W23921 DONNA DR, SUSSEX, WI 53089-2705
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
IL
Other
Enumeration date
06/09/2017
Last updated
06/09/2017
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