Individual
BRIAN JOHN GROSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
114 6TH AVE S, B, SURFSIDE BEACH, SC 29575-3501
(843) 712-1693
Mailing address
114 6TH AVE S, B, SURFSIDE BEACH, SC 29575-3501
(843) 712-1693
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
35687
SC
183500000X
Pharmacist
RP032982L
PA
Other
Enumeration date
08/04/2016
Last updated
08/04/2016
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