Individual
MISS ELIZABETH ROSE GRUBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
3030 BROADWAY, MAIL CODE 1915, NEW YORK, NY 10027-6907
(212) 854-3178
Mailing address
560 RIVERSIDE DR, 14M, NEW YORK, NY 10027-3202
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
001959-01
NY
Other
Enumeration date
01/31/2012
Last updated
01/31/2012
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