Individual
MR. JOHN DONELSON GROVE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLINICAL SOCIAL WORK
Contact information
Practice address
104 RUSKIN DRIVE, ALTOONA, PA 16602
(814) 215-3999
(814) 940-6308
Mailing address
104 RUSKIN DRIVE, ALTOONA, PA 16602
(814) 215-3999
(814) 940-6308
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
CW013302
PA
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000792941
HEALTH INSURANCE - B/C; B
PA
Enumeration date
07/19/2006
Last updated
04/10/2015
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