MR. Dale Forrest Grooms, ATC

NPI #1962581660 in Winnetka, Illinois

Provider Information

NPI Number: 1962581660
Entity Type: Individual
Name: MR. Dale Forrest Grooms, ATC
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Credential: ATC
Enumeration Date: Nov 3, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 385 WINNETKA AVE
City: Winnetka
State: Illinois
ZIP Code: 60093-4238
Phone: (847) 501-6445

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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Organizations

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