Individual
BETHANY GROGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1215 PLEASANT ST STE 618, DES MOINES, IA 50309
(515) 875-9090
(515) 875-9736
Mailing address
PO BOX 424, DES MOINES, IA 50302-0424
(515) 875-9925
(515) 875-9923
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
086376
IA
Other
Enumeration date
04/20/2017
Last updated
12/21/2023
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