Kristin Marie Groessl PA-C

NPI 1093797250 - Physician Assistant - 363AS0400X

NPI Details
NPI 1093797250
Gender Female
Enumeration Date 11/15/2005
Last Updated 09/14/2010
Entity Type Individual
Active Over 11 years ago
Practice Location
12203 CORPORATE PKWY
MEQUON WI, 53092-3388, US
Phone (262) 387-8200
Fax (262) 387-8271
Business Location
3003 W GOOD HOPE RD
MILWAUKEE WI, 53209-2042, US
Phone (414) 352-3100
Fax
Toxanomy
Taxonomy Code 363AS0400X
License State Wisconsin
License Number 1164-023
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According to our database, Kristin Marie Groessl PA-C NPI is 1093797250, taxonomy code is 363AS0400X and license number is 1164-023, license state is located at Wisconsin. Kristin Marie Groessl PA-C physically located at 12203 Corporate Pkwy, Mequon WI, 53092-3388. NPI Number Kristin Marie Groessl PA-C has the Individual type.

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1093797250 NPI number is provided on an as is basis without warranty of any kind. 1093797250 is maintained by the National Plan & Provider Enumeration System. The contents of Kristin Marie Groessl PA-C are for informational purposes only.