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Individual

ROBERT GRUVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAC

Contact information

Practice address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-3707
Mailing address
95 S PAGOSA BLVD, PAGOSA SPRINGS, CO 81147-8329
(970) 731-3700
(970) 731-3707

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
2936
CO
146D00000X
Personal Emergency Response Attendant
PA342
ID
363A00000X
Physician Assistant
Primary
PA60604308
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
16434234
CO
Enumeration date
04/25/2007
Last updated
01/23/2017
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