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General NPI Number Information
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NPI Number | 1598567919
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Entity Type | Organization
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Legal Business Name | GROW PELVIC HEALTH LLC
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Dates
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Enumeration Date | 03/26/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 6350 HARVEST TRAIL
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City | CHASKA
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State | MN
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Zip | 55318
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Country | US
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Telephone | 952-856-0844
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Fax | 833-871-8066
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Provider Business Mailing Address
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Address Line | 168 PIONEER TRL STE 235
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City | CHASKA
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State | MN
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Zip | 55318-1167
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Country | US
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Telephone | 952-856-0844
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Fax | 833-871-8066
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | COURTNEY SUILMANN
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Credential | MED, MOT, OTR/L
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Telephone | 952-856-0844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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