Individual
KEVIN CHARLES GROUSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
9601 INTERSTATE 630, EXIT 7, LITTLE ROCK, AR 72205-7202
(501) 202-2685
(501) 202-2003
Mailing address
9601 INTERSTATE 630, EXIT 7, LITTLE ROCK, AR 72205
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
1146
AR
Other
Enumeration date
11/17/2007
Last updated
11/17/2007
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