Individual
GROVER L HUBBARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1262 MAIN ST, SWEET HOME, OR 97386-1608
(541) 913-9501
(541) 367-8093
Mailing address
1262 MAIN ST, SWEET HOME, OR 97386-1608
(541) 913-9501
(541) 367-8093
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20473
OR
Other
Enumeration date
05/24/2014
Last updated
05/24/2014
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