Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 2301007175 | MI |
NPI | 1144284167 |
---|---|
Provider Name | Dr. Sean Patrick Groves |
First Address | Coldwater, MI 49036-8130 |
Second Address | Coldwater, MI 49036-8130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2006 |
Last Update Date | 01/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4314403 | (05) | MI |
950A250160 | BCBSM (01) | MI |
U53657 | (02) | MI |