Provider Demographics
NPI:1174048151
Name:GROVE, CHRISTIAN ABRAHAM (DPT)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:ABRAHAM
Last Name:GROVE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5425 JONESTOWN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-4086
Mailing Address - Country:US
Mailing Address - Phone:717-901-6245
Mailing Address - Fax:717-901-9488
Practice Address - Street 1:5425 JONESTOWN RD STE 100
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-4086
Practice Address - Country:US
Practice Address - Phone:717-901-6245
Practice Address - Fax:717-901-9488
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT026253225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist