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Individual

RENAE MICHELLE GRUVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
9385 W DONALD DR, PEORIA, AZ 85383-2988
(602) 875-5616
Mailing address
2898 E CITADEL CT, GILBERT, AZ 85298-5728
(480) 710-8632

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6898
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
052151
AZ
Enumeration date
05/11/2007
Last updated
12/15/2020
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