Individual
AMY DAWN GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10593 LONG JOHN SILVER TRL, HILLSBORO, OH 45133-7302
(937) 205-9774
Mailing address
10593 LONG JOHN SILVER TRL, HILLSBORO, OH 45133-7302
(937) 205-9774
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
402115641018
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71968750
—
OH
Enumeration date
10/24/2022
Last updated
10/24/2022
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