Male or Other

Mr. Gregory W. Jolly L.M.T.

Massage Therapist in Wauwatosa, WI(View on Map)

Full Name

Mr. Gregory William Jolly L.M.T.

NPI Number

1821339847

NPI Type

Individual Provider

Gender

Male

Enumeration Date

03/15/2013

Specialties

(Taxonomies)

Code

225700000X

Primary Taxonomy

Yes

Licenses

State

Wisconsin

License Number

821-146

Contact
Information

Purpose

Mailing
Location

Address

5653 N STANTON DR
8320 W BLUEMOUND RD

City

Glendale
Wauwatosa

State

WI
WI

Postal Code

53209-4357
53213-3367

Country

US
US

Telephone Number

(414) 238-3229
(414) 302-3800

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/15/2013

Provider Address

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