Provider Demographics
NPI:1316991508
Name:GROVE, MATTHEW ARNOLD (DC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ARNOLD
Last Name:GROVE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5040
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-532-8584
Mailing Address - Fax:530-532-8433
Practice Address - Street 1:1611 FEATHER RIVER BLVD STE 110
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95965
Practice Address - Country:US
Practice Address - Phone:530-534-4530
Practice Address - Fax:530-532-8290
Is Sole Proprietor?:No
Enumeration Date:2006-05-20
Last Update Date:2011-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25061111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC25061OtherBLUE CROSS OF CA
CADC0250610OtherBLUE SHIELD OF CA
CADC0250610OtherBLUE SHIELD OF CA