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1154705119
JOHNNY ALLEN GROOMS
PARAGOULD, AR
NPI
1154705119
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
(Licence: AR AT284)
Enumeration Date
2015-07-19
Last Update Date
2015-07-19
Business Address
MR. JOHNNY ALLEN GROOMS
1808 CLOVERDALE ST
PARAGOULD, AR 72450-5894
Phone number: 870-476-9698
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Mailing Address
MR. JOHNNY ALLEN GROOMS
1808 CLOVERDALE ST
PARAGOULD, AR 72450-5894
Phone number: 870-476-9698
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