Healthcare Provider Details

I. General information

NPI: 1285030908
Provider Name (Legal Business Name): KARA GRUBB D.V.M.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16575 WASHINGTON ST
THORNTON CO
80023-8971
US

IV. Provider business mailing address

16575 WASHINGTON ST
THORNTON CO
80023-8971
US

V. Phone/Fax

Practice location:
  • Phone: 720-977-7124
  • Fax: 720-977-7147
Mailing address:
  • Phone: 720-977-7124
  • Fax: 720-977-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number9480
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: