Healthcare Provider Details

I. General information

NPI: 1932027257
Provider Name (Legal Business Name): THERESA GROESCHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11040 N STATE ROAD 77
HAYWARD WI
54843-6391
US

IV. Provider business mailing address

10271 N COUNTY ROAD K
HAYWARD WI
54843-6622
US

V. Phone/Fax

Practice location:
  • Phone: 715-934-4321
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: