Provider Demographics
NPI:1891417499
Name:GROPPI, CLAIRISSA (PTA)
Entity Type:Individual
Prefix:
First Name:CLAIRISSA
Middle Name:
Last Name:GROPPI
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:CLAIRISSA
Other - Middle Name:
Other - Last Name:RACE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1712 HOLTON RD
Mailing Address - Street 2:
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-3408
Mailing Address - Country:US
Mailing Address - Phone:231-719-1921
Mailing Address - Fax:
Practice Address - Street 1:1712 HOLTON RD
Practice Address - Street 2:
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-3408
Practice Address - Country:US
Practice Address - Phone:231-719-1921
Practice Address - Fax:231-719-9470
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5502006381225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant