Individual
MARY B GROSVENOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
1501 E 3RD ST, DELTA, CO 81416-2815
(970) 874-7681
Mailing address
PO BOX 10100, DELTA, CO 81416-0008
(970) 874-2470
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
637966
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
840428757016
ROCKY MOUNTAIN HEALTH PLA
CO
01
—
840428757037
ROCKY MOUNTAIN HEALTH PLA
CO
01
—
GR675759
BCBS
CO
Enumeration date
06/22/2006
Last updated
03/13/2008
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