Provider Demographics
NPI:1184480873
Name:GROBE, CHAZ
Entity type:Individual
Prefix:
First Name:CHAZ
Middle Name:
Last Name:GROBE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 LITTLE SOLIDA RD # B
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-9354
Mailing Address - Country:US
Mailing Address - Phone:304-518-4118
Mailing Address - Fax:
Practice Address - Street 1:708 LITTLE SOLIDA RD # B
Practice Address - Street 2:
Practice Address - City:SOUTH POINT
Practice Address - State:OH
Practice Address - Zip Code:45680-9354
Practice Address - Country:US
Practice Address - Phone:304-518-4118
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker