Individual
CARLY GROVHOUG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
111 MAIN ST STE B, WINTERS, CA 95694-1930
(530) 795-4591
(530) 795-0315
Mailing address
10470 OLD PLACERVILLE RD STE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A128377
CA
Other
Enumeration date
04/05/2012
Last updated
09/26/2016
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