| Doctor Name: | VICTORIA ANNE GRUBE |
| NPI Number: | 1003116864 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 126 Missouri Ave Fort Leonard Wood, MO - 654738952 |
| Business Phone Number: | 5735961682 |
| Business Fax Number: | |
| Mailing Address: | 23350 Ross Rd, WAYNESVILLE |
| State: | MO |
| Postal Code: | 655832756 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2010 |
| NPI Last Update Date: | 10/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QI0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Immunology |
| Taxonomy Definition: | |