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General NPI Number Information
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NPI Number | 1689703399
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Entity Type | Individual
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Provider Name | TONIA GRUPPEN A.T.C.
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 222 FAIRBANKS AVE
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City | HOLLAND
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State | MI
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Zip | 49423-3735
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Country | US
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Telephone | 616-395-7455
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Fax |
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Provider Business Mailing Address
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Address Line | 9233 GARDEN VIEW DR
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City | ZEELAND
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State | MI
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Zip | 49464-2149
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Country | US
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Telephone | 616-748-2507
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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