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Organization

CLEVELAND HEALTH VENTURES, LLC

Active
Other names
Grover Family Practice
Organization subpart
No

Provider details

NPI number
Authorized official
DANIEL L WIENS (SENIOR VICE PRESIDENT)
(704) 355-0648
Entity
Organization

Contact information

Practice address
217 N MAIN ST., GROVER, NC 28073
(704) 937-7905
(704) 937-9449
Mailing address
5000 AIRPORT CENTER PKWY STE A, CHARLOTTE, NC 28208-5899
(704) 512-4116
(704) 371-7284

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89015J4
NC
Enumeration date
07/04/2006
Last updated
08/22/2020
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