Individual
GARY LEE GROOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1424 E FOREMASTER DR, SUITE 120, ST GEORGE, UT 84790-6326
(435) 656-8800
(435) 627-1809
Mailing address
PO BOX 727, BRIGHAM, UT 84302
(435) 734-0101
(435) 734-0103
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1136132501
UT
Other
Enumeration date
05/17/2006
Last updated
11/15/2007
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