Organization
FULL CIRCLE HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
E. VICTORIA GROVER PA-C (CEO)
(207) 764-7200
Entity
Organization
Contact information
Practice address
167 ACADEMY ST STE C, PRESQUE ISLE, ME 04769-3167
(207) 764-7200
(207) 764-7204
Mailing address
167 ACADEMY ST STE C, PRESQUE ISLE, ME 04769-3167
(207) 764-7200
(207) 764-7204
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3670329
AETNA GRP #
ME
05
—
422610000
—
ME
01
—
DC9845
RAILROAD GRP #
ME
Enumeration date
05/03/2006
Last updated
05/11/2022
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