Individual
EDWARD GROUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
134 FALCON DR, GREEN COVE SPRINGS, FL 32043-6535
(904) 443-3500
(904) 443-1783
Mailing address
134 FALCON DR, GREEN COVE SPRINGS, FL 32043-6535
(904) 443-3500
(904) 443-1783
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2978
OH
152W00000X
Optometrist
922
OK
Other
Enumeration date
02/07/2017
Last updated
02/07/2017
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