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General NPI Number Information
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NPI Number | 1124981287
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Entity Type | Organization
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Legal Business Name | THE GROVE HEALING CENTER, LLC
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Dates
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Enumeration Date | 12/05/2025
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 6123 W NORTH AVE
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City | MILWAUKEE
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State | WI
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Zip | 53213-1529
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Country | US
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Telephone | 262-617-3908
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Fax |
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Provider Business Mailing Address
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Address Line | 6123 W NORTH AVE
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City | MILWAUKEE
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State | WI
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Zip | 53213-1529
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Country | US
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Telephone | 262-617-3908
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Fax |
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Authorized Official
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Title or Position | ACUPUNCTURIST
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Name | AMANDA RINDAL
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Credential | L.AC, MSAHM, BSN
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Telephone | 262-617-3908
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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