Individual
MRS. IRMA G COLGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9102 CAMINO LAGO VIS, SPRING VALLEY, CA 91977-6425
(619) 954-1105
Mailing address
9192 CAMINO LAGO VIS, SPRING VALLEY, CA 91977
(619) 954-1105
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
00455387
CA
Other
Enumeration date
03/28/2017
Last updated
03/28/2017
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