STEPHANIE WISE GROSVENOR

FORT WAYNE, IN
NPI1912193640
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy207V00000X Obstetrics & Gynecology
(Licence: IN  02006694A)
Additional Taxonomies207V00000X Obstetrics & Gynecology
(Licence: MI  1132870)
Enumeration Date2007-09-17
Last Update Date2023-02-01
Business Address
Dr. STEPHANIE WISE GROSVENOR D.O.
10228 DUPONT CIRCLE DR E STE 100
FORT WAYNE, IN 46825-1611
Phone number: 260-222-7401
Mailing Address
Dr. STEPHANIE WISE GROSVENOR D.O.
PO BOX 772437
DETROIT, MI 48277-2437
Phone number: 317-575-7304