Collin Patrick Groves
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Mukwonago, WI
NPI 1760923866 · NPPES record last updated Mar 9, 2017
Key facts
- NPI
- 1760923866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 644 Prairie Hill Ave
Mukwonago, WI 53149-8932 - Phone
- (262) 891-7057
- NPI assigned
- Mar 9, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
644 Prairie Hill Ave
Mukwonago, WI 53149-8932
Mailing address
644 Prairie Hill Ave
Mukwonago, WI 53149-8932
Phone (262) 891-7057
Other providers in Mukwonago, WI
- Four a'S Helping Lives
- Jennifer L Friehe
- Kyla Galles
- Jeffrey D Gentile
- William Harry Green
- H.S. Psychological Services SC
- Lisa Haisler
- Anthony Thomas Hall
- Kelly Elizabeth Halpin
- Rebecca Halverson
All providers in Mukwonago, WI · Student in an Organized Health Care Education/Training Program in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 9, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.