MEDICARE: MRS. CHRISTIE JEAN GROVER M.P.T., CERT. M.D.T

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374J00000X	Doula		NJ
2	225100000X	Physical Therapist	40QA00621700	NJ

General Provider Information

NPI Number	:	1336149798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHRISTIE JEAN GROVER M.P.T., CERT. M.D.T

Provider Business Mailing Address
First Line	:	144 STONEBROOK DR
Second Line	:
City	:	LUMBERTON
State	:	NJ
Zip	:	08048-4505
Country	:	US
Telephone Number	:	609-267-1486
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 FRANKLIN CORNER RD
Second Line	:	SUITE 103
City	:	LAWRENCEVILLE
State	:	NJ
Zip	:	08648-2526
Country	:	US
Telephone Number	:	609-896-9054
Fax Number	:	609-896-9059

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	10/15/2024

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