Healthcare Provider Details

I. General information

NPI: 1427975283
Provider Name (Legal Business Name): CASSANDRA ANN GROVES L-HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3536 HAMMONS BLVD
JOPLIN MO
64804-6037
US

IV. Provider business mailing address

3536 HAMMONS BLVD
JOPLIN MO
64804-6037
US

V. Phone/Fax

Practice location:
  • Phone: 417-659-8908
  • Fax:
Mailing address:
  • Phone: 417-659-8908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2015001264
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: