Individual
ADNEY RAUL GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
102 W MAIN ST, SAN JACINTO, CA 92583-4121
(951) 663-4848
Mailing address
PO BOX 3868, HEMET, CA 92546-3868
(951) 663-4848
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689715591
—
CA
Enumeration date
06/19/2012
Last updated
06/19/2012
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