Individual
MISS DESTINEE HOPE GROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAT, ATC
Contact information
Practice address
4901 STATE ST, EAST SAINT LOUIS, IL 62205-1356
(618) 646-3000
Mailing address
4497 PERSHING AVE APT 702, SAINT LOUIS, MO 63108-2529
(910) 876-4166
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
12/13/2022
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