Individual
KERRI GROTHAUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LAT, ATC
Contact information
Practice address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(419) 979-2129
Mailing address
3946 ICE WAY, FORT WAYNE, IN 46805-1018
(419) 979-2129
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36002808A
IN
2255A2300X
Athletic Trainer
AT005479
OH
Other
Enumeration date
09/07/2015
Last updated
12/04/2024
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