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General NPI Number Information
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NPI Number | 1346419629
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Entity Type | Organization
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Legal Business Name | JAMES GROVE & ASSOCIATES, LLC
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Dates
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Enumeration Date | 02/21/2008
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 4907 SECURITY DR
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City | SPRINGFIELD
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State | OH
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Zip | 45503-5651
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Country | US
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Telephone | 937-399-3223
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Fax | 937-399-3225
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Provider Business Mailing Address
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Address Line | 4907 SECURITY DR
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City | SPRINGFIELD
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State | OH
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Zip | 45503-5651
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Country | US
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Telephone | 937-399-3223
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Fax | 937-399-3225
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Authorized Official
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Title or Position | MEMBER
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Name | DR. JAMES D GROVE
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Credential | O.D.
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Telephone | 937-399-3223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 5180
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License Number State | OH
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