Individual
MARY JO GROVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1117 SPRING ST, FRIDAY HARBOR, WA 98250
(360) 378-2141
(360) 378-1785
Mailing address
2665 DERR ROAD, SPRINGFIELD, OH 45503-3774
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.046580
OH
207Q00000X
Family Medicine Physician
G156583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0466473
—
OH
Enumeration date
06/18/2006
Last updated
08/29/2018
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