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Individual

JUSTIN GROOMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
413 N DONNIVAN ST, PRINCETON, KY 42445-1311
(657) 217-4006
Mailing address
6100 DE SOTO AVE APT 1235, WOODLAND HILLS, CA 91367-3784
(657) 217-4006

Taxonomy

Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
KY
374U00000X
Home Health Aide
Primary
KY

Other

Enumeration date
09/03/2025
Last updated
09/03/2025
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