Grocholski, Tara M.

Grocholski, Tara M. is an individual health care provider with primary practice located at 700 Geneva Pkwy N , Lake Geneva WI 53147-4594. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Grocholski, Tara M. can be contacted via phone (262) 249-3500.

Contact Information

Primary practice address
700 Geneva Pkwy N Lake Geneva WI 53147-4594
Phone: (262) 249-3500
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 6118-024 Wisconsin

Profile Details

NPI number 1134217763
LBN Legal business name Grocholski, Tara M.
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 10th, 2006
Last updated Jan 15th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134217763 NPPES
Wisconsin MEDICAID 40366700
Wisconsin Other 0604410001
Wisconsin Other 005085940

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