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General NPI Number Information
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NPI Number | 1326250051
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Entity Type | Individual
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Provider Name | MRS. CYNTHIA LOUISE GRUBBS
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 1 MILE N. PINON, ROUTE 41
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-725-2130
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Fax | 928-725-2135
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Provider Business Mailing Address
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Address Line | 112 TAYLOR ST
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City | STERLING
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State | CO
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Zip | 80751-4115
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Country | US
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Telephone | 970-521-0103
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | AZ
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