Provider Information for 1487766580
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Mr. GRANT SIMPSON GROVER A.C.S.W.
Sex: Male
NPI: 1487766580
Last Updated: 2007-07-08
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1487766580 | ||||||||
| Enumeration Date | 2006-08-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1728 PLUTO WAY SACRAMENTO, CA 95864-1716 United States Phone: 916-384-8096 | Fax: | ||||||||
| Primary Practice Address | 7245 E SOUTHGATE DR SACRAMENTO, CA 95823-2620 United States Phone: 916-427-7141 | Fax: | ||||||||
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