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General NPI Number Information
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NPI Number | 1730061664
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Entity Type | Organization
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Legal Business Name | GROVE CREEK SURGICENTER, LLC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 2168 W GROVE PKWY STE 101
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6745
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Country | US
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Telephone | 801-772-5050
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Fax | 801-756-7498
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Provider Business Mailing Address
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Address Line | 2168 W GROVE PKWY STE 101
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City | PLEASANT GROVE
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State | UT
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Zip | 84062-6745
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Country | US
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Telephone | 801-772-5050
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Fax | 801-756-7498
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Authorized Official
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Title or Position | CFO
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Name | DAVID MCKNIGHT
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Credential |
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Telephone | 972-789-2816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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