Individual
BENJAMIN RANDOLPH GROVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4040 ORCHARD ST W, STE. 100, FIRCREST, WA 98466-6606
(253) 564-1560
(253) 564-4449
Mailing address
4040 ORCHARD ST W, STE. 100, FIRCREST, WA 98466-6606
(253) 564-1560
(253) 564-4449
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60274732
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0306754
STATE OF WASHINGTON DEPT. OF LABOR AND INDUSTRIES
WA
Enumeration date
01/09/2013
Last updated
05/07/2013
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