Individual
TERRY GRUBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S. ED.
Contact information
Practice address
5699 S FORK LITTLE CACAPON RD, SHANKS, WV 26761-9128
(304) 257-0240
Mailing address
5699 S FORK LITTLE CACAPON RD, SHANKS, WV 26761-9128
(304) 257-0240
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
E2R098400085
WV
Other
Enumeration date
03/18/2020
Last updated
12/30/2024
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