Individual
MR. RYAN S GROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7500 SW 30TH ST, DAVIE, FL 33314-1020
(954) 452-7008
(954) 452-7069
Mailing address
3483 CRYSTAL LN, DAVIE, FL 33330-4630
(412) 292-6249
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
AL 3939
FL
174400000X
Specialist
RT001346A
PA
Other
Enumeration date
09/05/2005
Last updated
01/12/2015
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