Individual
JESSICA MARIE DEGROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
614 MEMORIAL DR, CHILTON, WI 53014-1568
(920) 849-2386
Mailing address
11 ALGOMA ST, FOND DU LAC, WI 54935-3601
(920) 979-0194
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6006
WI
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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