Individual
MRS. DONNA GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1951 W 25TH ST, STE. C, YUMA, AZ 85364-6925
(928) 726-7900
(928) 726-7901
Mailing address
4467 W VAQUERO LN, YUMA, AZ 85365-8060
(928) 276-5422
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1160
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AZ0293620
BLUE CROSS OF AZ
AZ
Enumeration date
10/12/2006
Last updated
04/15/2013
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