Individual
BRYAN D GROOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
PO BOX 155, WINCHESTER, OH 45697-0155
(937) 695-0770
(888) 230-8394
Mailing address
PO BOX 155, WINCHESTER, OH 45697-0155
(937) 695-0770
(888) 230-8394
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34.010744
OH
207Q00000X
Family Medicine Physician
TP627
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0081452
—
OH
Enumeration date
06/28/2011
Last updated
11/10/2017
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