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NPI Code Detail

MEDICARE: STEPHANIE L GROENKE

MEDICARE:   STEPHANIE L GROENKE
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
1225100000XPhysical Therapist012901OH

General Provider Information

NPI Number : 1285947549
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE L GROENKE
Provider Business Mailing Address
First Line : 4301 CLIME RD N
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-3403
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4301 CLIME RD N
Second Line :
City : COLUMBUS
State : OH
Zip : 43228-3403
Country : US
Telephone Number : 614-824-4079
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2010
Last Update Date : 07/15/2010

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Directions to “ STEPHANIE L GROENKE ” Practice Location

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