Healthcare Provider Details

I. General information

NPI: 1639512874
Provider Name (Legal Business Name): APRIL CHRISTINE GROTHE DVM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2013
Last Update Date: 04/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5714 W 13400 S
HERRIMAN UT
84096-6907
US

IV. Provider business mailing address

5714 W 13400 S
HERRIMAN UT
84096-6907
US

V. Phone/Fax

Practice location:
  • Phone: 801-446-5194
  • Fax: 801-446-6343
Mailing address:
  • Phone: 801-446-5194
  • Fax: 801-446-6343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number19092
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number8472652-2801
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: