Individual
MISS MICHELLE KAYE GROVER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
3415 N 59TH AVE, PHOENIX, AZ 85033-4623
(602) 763-2984
Mailing address
206 E LAWRENCE BLVD APT 119, AVONDALE, AZ 85323-1946
(602) 763-2984
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0121
AZ
Other
Enumeration date
12/18/2006
Last updated
02/08/2012
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