Individual
DUSTIN ROBERT GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, ACE
Contact information
Practice address
160 WAHOO WAY, APT 212, CHARLOTTESVILLE, VA 22903-4154
(513) 520-3804
Mailing address
160 WAHOO WAY, APT 212, CHARLOTTESVILLE, VA 22903-4154
(513) 520-3804
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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