Individual
KEITH GUY GROOVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARRT R.T. (R)(CT)
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6061
Mailing address
733 LELAND DASHER RD, GLENNVILLE, GA 30427-6460
(912) 977-3102
Taxonomy
Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
441602
GA
2471C3401X
Computed Tomography Radiologic Technologist
Primary
441602
GA
2471C3402X
Radiography Radiologic Technologist
441602
GA
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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