Organization
EMERALD GROVE WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN GANTER LPC (OWNER)
(724) 766-3825
Entity
Organization
Contact information
Practice address
214 BRICKYARD RD, MARS, PA 16046-3006
(724) 766-3825
(334) 344-7725
Mailing address
214 BRICKYARD RD, MARS, PA 16046-3006
(724) 766-3825
(334) 344-7725
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
11/08/2020
Last updated
11/08/2020
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