Individual
KIMBERLEY T GROVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
3027 HWY 83, LAZY PINE MALL, SEELEY LAKE, MT 59868
(406) 677-7722
(406) 677-7723
Mailing address
PO BOX 135, SEELEY LAKE, MT 59868-0135
(406) 677-7722
(406) 677-7723
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1478PT
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000060303
BC/BS
MT
05
—
3400904
—
MT
01
—
60303
MEDICARE ADVANTAGE
MT
Enumeration date
09/08/2006
Last updated
10/09/2007
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