Provider Demographics
NPI:1750582854
Name:GROVER, CHRISTIAN D (MS)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:D
Last Name:GROVER
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 WINNE AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4917
Mailing Address - Country:US
Mailing Address - Phone:406-443-8838
Mailing Address - Fax:406-443-6367
Practice Address - Street 1:2626 WINNE AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4917
Practice Address - Country:US
Practice Address - Phone:406-443-8838
Practice Address - Fax:406-443-6367
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT250231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0539188Medicaid
MT569036Medicaid