Organization
GC GROVER BS DC PC
Active
Other names
Moon Valley Chiropractic
Organization subpart
No
Provider details
NPI number
Authorized official
GARY GROVER (PRESIDENT)
(602) 298-0292
Entity
Organization
Contact information
Practice address
15420 NORTH 7TH ST, SUITE B, PHOENIX, AZ 85022
(602) 298-0292
(602) 298-6961
Mailing address
15420 NORTH 7TH ST, SUITE B, PHOENIX, AZ 85022
(602) 298-0292
(602) 298-6961
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3782
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0249810
BCBS OF AZ PROVIDER #
AZ
Enumeration date
07/28/2006
Last updated
07/17/2008
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