Groth, Kevin P

Groth, Kevin P is an sole proprietor health care provider with primary practice located at 1540 Heritage Blvd Suite 203, West Salem WI 54669. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Groth, Kevin P can be contacted via phone (608) 786-3670.

Contact Information

Primary practice address
1540 Heritage Blvd Suite 203 West Salem WI 54669
Fax: (608) 786-3672
Website:

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 4109-012 Wisconsin

Profile Details

NPI number 1255350542
LBN Legal business name Groth, Kevin P
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 18th, 2006
Last updated Oct 14th, 2015 - about 10 years ago

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 1255350542 NPPES
Wisconsin Other P00600195 MEDICARE RAILROAD
Wisconsin MEDICAID 38959600 MEDICARE RAILROAD

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