Provider Demographics
NPI:1770642860
Name:GROW, CHRISTOPHER SCOTT (PA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:GROW
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Gender:M
Credentials:PA
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Mailing Address - Street 1:2250 GAUSE BLVD E
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-4235
Mailing Address - Country:US
Mailing Address - Phone:985-641-7775
Mailing Address - Fax:985-641-1166
Practice Address - Street 1:2250 GAUSE BLVD E
Practice Address - Street 2:SUITE 200
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-4235
Practice Address - Country:US
Practice Address - Phone:985-641-7775
Practice Address - Fax:985-641-1166
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2023-06-01
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Provider Licenses
StateLicense IDTaxonomies
LAPA.,A10401.RX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical