Organization
HOMETOWN PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THRESA L GROTHAUS APRN (CPNP)
(419) 236-3434
Entity
Organization
Contact information
Practice address
152 W 2ND ST, DELPHOS, OH 45833-1601
(567) 765-1111
(833) 940-3627
Mailing address
308 TAFT ST, COLUMBUS GROVE, OH 45830-1122
(419) 236-3434
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0133929
—
OH
Enumeration date
04/13/2022
Last updated
04/03/2023
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