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Individual
MICHAEL A GROSSNICKLE
Active
Individual
MICHAEL A GROSSNICKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0015591
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500750146
—
OR
Enumeration date
09/20/2016
Last updated
07/08/2022
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