| NPI | 1821637141 |
|---|---|
| Other Name | KATHERINE M GROAT |
| Entity Type | Organization |
| Authorized Contact | KATHERINE M GROAT Owner 669-224-2066 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2020-01-03 |
| Last Update Date | 2020-01-03 |