Healthcare Provider Details

I. General information

NPI: 1952237570
Provider Name (Legal Business Name): LIAM GROVES EMT-B
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 AIRFIELD RD, TM2 6082C
APO AA
80918
US

IV. Provider business mailing address

3524 AIRFIELD RD, TM2 6082C
APO AA
80918
US

V. Phone/Fax

Practice location:
  • Phone: 719-524-6524
  • Fax:
Mailing address:
  • Phone: 719-524-6524
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License NumberE3427826
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: