Provider Demographics
NPI:1275565756
Name:GROVE, JOY JENNIFER (PT)
Entity Type:Individual
Prefix:MRS
First Name:JOY
Middle Name:JENNIFER
Last Name:GROVE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:JOY
Other - Middle Name:JENNIFER
Other - Last Name:SKALET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:1550 JESS PARRISH CT
Mailing Address - Street 2:
Mailing Address - City:TITUSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32796-2147
Mailing Address - Country:US
Mailing Address - Phone:321-269-2200
Mailing Address - Fax:
Practice Address - Street 1:1550 JESS PARRISH CT
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32796-2147
Practice Address - Country:US
Practice Address - Phone:321-269-2200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05006886A225100000X
FLPT23669225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist