Individual
ELIZABETH TOEBBE GROUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2888 E LONG LAKE RD STE 105, TROY, MI 48085-3700
(248) 689-1330
(248) 689-6424
Mailing address
2888 E LONG LAKE RD STE 105, TROY, MI 48085-3700
(859) 801-3679
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601008168
MI
363A00000X
Physician Assistant
PA1953
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100325980
—
KY
Enumeration date
09/16/2014
Last updated
07/21/2022
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