Individual
BETHANY MARIE GRUBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2001 VAIL AVE, CHARLOTTE, NC 28207-1248
(704) 304-6070
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03542
NC
Other
Enumeration date
06/12/2012
Last updated
05/08/2024
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