Individual
BRYAN ALAN GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
455 E PIKES PEAK AVE STE 220, COLORADO SPRINGS, CO 80903-3673
(719) 475-8080
(719) 475-0913
Mailing address
455 E PIKES PEAK AVE, SUITE 220, COLORADO SPRINGS, CO 80903-3648
(719) 475-8080
(719) 475-0913
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
593
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85559075
—
CO
Enumeration date
06/02/2006
Last updated
06/15/2021
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