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Individual
JACOB WESLEY GROSETH
Active
Individual
JACOB WESLEY GROSETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
PT33205
FL
363AS0400X
Surgical Physician Assistant
145866
FL
Other
Enumeration date
11/04/2013
Last updated
12/14/2017
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