(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003535071
Provider Name: MAGNOLIA MAE GRENAWALT PTA
Entity Type: Individual
Taxonomy Code: 208100000X
Specialty: Physical Medicine & Rehabilitation
License Number: 4002-19
Most Important Dates
Enumeration Date: 08/24/2022
Last Updated: 08/24/2022
Provider Practice Location
600 2ND AVE
NEW GLARUS
WI
535749776
Practice Location Phone/Fax
Phone: 6085274390
Fax:
Provider Mailing Location
600 2ND AVE
NEW GLARUS
WI
535749776
Provider Mailing Phone/Fax
Phone: 6085274390
Fax: