Provider Demographics
NPI:1619059730
Name:GROVER, LOREN T (DC)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:T
Last Name:GROVER
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 1:1061 CREEK VIEW DR
Mailing Address - Street 2:
Mailing Address - City:FRUIT HEIGHTS
Mailing Address - State:UT
Mailing Address - Zip Code:84037-2654
Mailing Address - Country:US
Mailing Address - Phone:801-451-6010
Mailing Address - Fax:
Practice Address - Street 1:1061 CREEK VIEW DR
Practice Address - Street 2:
Practice Address - City:FRUIT HEIGHTS
Practice Address - State:UT
Practice Address - Zip Code:84037
Practice Address - Country:US
Practice Address - Phone:801-451-6010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6133627-1202111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician
No111NN1001XChiropractic ProvidersChiropractorNutrition