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Individual
JUSTIN GROH
Active
Individual
JUSTIN GROH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP450543
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP450543
PA STATE BOARD OF PHARMACY
PA
Enumeration date
01/09/2017
Last updated
01/09/2017
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