| Doctor Name: | MR. RYAN S GROVE |
| NPI Number: | 1659365781 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ATC |
| License Number: | RT001346A |
| Business Practice Address: | 7500 Sw 30th St Davie, FL - 333141020 |
| Business Phone Number: | 9544527008 |
| Business Fax Number: | 9544527069 |
| Mailing Address: | 3483 Crystal Ln, DAVIE |
| State: | FL |
| Postal Code: | 333304630 |
| Phone Number: | 4122926249 |
| Fax Number: | |
| NPI Enumeration Date: | 09/05/2005 |
| NPI Last Update Date: | 01/12/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | RT001346A |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |