Healthcare Provider Details

I. General information

NPI: 1386746659
Provider Name (Legal Business Name): JULIE GLENN GROVER MD, PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2006
Last Update Date: 02/12/2025
Certification Date: 02/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

395 W COUGAR BLVD STE 203
PROVO UT
84604-3328
US

IV. Provider business mailing address

PO BOX 27128
SALT LAKE CITY UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 801-357-7009
  • Fax: 801-357-8132
Mailing address:
  • Phone: 801-357-7009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number376454-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: