Most Relevant Information
Provider Data
| NPI Number: | 1003457508 |
| Provider Name: | DAVID GROAT |
| Entity Type: | Individual |
| Taxonomy Code: | 310400000X |
| Specialty: | Assisted Living Facility |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/05/2019 |
| Last Updated: | 10/05/2019 |
Provider Practice Location
2650 N GARNET LN
WASILLA
AK
996543414
Practice Location Phone/Fax
| Phone: | 9073558677 |
| Fax: |
Provider Mailing Location
2650 N GARNET LN
WASILLA
AK
996543414
Provider Mailing Phone/Fax
| Phone: | 9073558677 |
| Fax: |