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NPI Code Detail

MEDICARE: THE GROVE HEALING CENTER, LLC

MEDICARE: THE GROVE HEALING CENTER, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171100000XAcupuncturist

General Provider Information

NPI Number : 1124981287
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE GROVE HEALING CENTER, LLC
Provider Business Mailing Address
First Line : 6123 W NORTH AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53213-1529
Country : US
Telephone Number : 262-617-3908
Fax Number :
Provider Business Practice Location Address
First Line : 6123 W NORTH AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53213-1529
Country : US
Telephone Number : 262-617-3908
Fax Number :
Authorized Official
Title or Position : ACUPUNCTURIST
Name : AMANDA RINDAL
Credential : L.AC, MSAHM, BSN
Telephone Number : 262-617-3908
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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Directions to “THE GROVE HEALING CENTER, LLC ” Practice Location

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