Most Relevant Information
Provider Data
| NPI Number: | 1003543372 |
| Provider Name: | MAHALA GROHMAN LPN |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 238896 |
Most Important Dates
| Enumeration Date: | 08/05/2022 |
| Last Updated: | 08/05/2022 |
Provider Practice Location
910 E WASHINGTON ST
PHOENIX
AZ
850341006
Practice Location Phone/Fax
| Phone: | 6025235885 |
| Fax: |
Provider Mailing Location
910 E WASHINGTON ST
PHOENIX
AZ
850341006
Provider Mailing Phone/Fax
| Phone: | 6025235885 |
| Fax: |