Individual
MRS. THERESA LEE GROTHJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5225 E CRYSTAL LN, COTTONWOOD, AZ 86326-6066
(949) 463-4629
Mailing address
5225 E CRYSTAL LN, COTTONWOOD, AZ 86326-6066
(949) 463-4629
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
Primary
RN388521
CA
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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