Provider Demographics
NPI:1316199623
Name:GRUBB, ROBERT STEVEN (HIS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:STEVEN
Last Name:GRUBB
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3953 LEGION LN
Mailing Address - Street 2:
Mailing Address - City:CASPER
Mailing Address - State:WY
Mailing Address - Zip Code:82609-1942
Mailing Address - Country:US
Mailing Address - Phone:307-237-5813
Mailing Address - Fax:307-237-2329
Practice Address - Street 1:3953 LEGION LN
Practice Address - Street 2:
Practice Address - City:CASPER
Practice Address - State:WY
Practice Address - Zip Code:82609-1942
Practice Address - Country:US
Practice Address - Phone:307-237-5813
Practice Address - Fax:307-237-2329
Is Sole Proprietor?:No
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY147237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist