Individual
JUSTIN GRUENEICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4255 30TH AVE S, FARGO, ND 58104-8427
(701) 478-8122
(701) 478-8127
Mailing address
107 E LINCOLN AVE, FERGUS FALLS, MN 56537-2216
(218) 736-5565
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
119577
MN
183500000X
Pharmacist
Primary
RPH5639
ND
Other
Enumeration date
06/12/2013
Last updated
06/15/2021
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