Individual
DANIELLE GROOMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5449 LONGVIEW DR, CROSS LANES, WV 25313-1514
(304) 541-0366
Mailing address
5449 LONGVIEW DR, CROSS LANES, WV 25313-1514
(304) 541-0366
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
TT0011411
WV
Other
Enumeration date
06/08/2016
Last updated
06/08/2016
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