Individual
SHANNON GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
500 POLK ST STE 24, GREENWOOD, IN 46143-1638
(317) 796-5740
Mailing address
241 E BRUNSWICK AVE, INDIANAPOLIS, IN 46227-2047
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
952699
IN
Other
Enumeration date
12/05/2017
Last updated
12/05/2017
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