Individual
TIMOTHY J GRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10101 S 27TH ST, FRANKLIN, WI 53132-7209
(414) 325-4940
Mailing address
10101 S 27TH ST, FRANKLIN, WI 53132-7209
(414) 325-4940
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38321
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30091700
—
WI
Enumeration date
08/20/2006
Last updated
03/07/2023
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