Individual
MYRISSA GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2759 SCOTCHBROOM PT, COLORADO SPRINGS, CO 80910-4452
(715) 456-6400
Mailing address
2759 SCOTCHBROOM PT, COLORADO SPRINGS, CO 80910-4452
(715) 456-6400
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA.0008496
CO
Other
Enumeration date
08/21/2024
Last updated
08/21/2024
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