Individual
GREGORY D BLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2410 W FOREST HOME AVE, MILWAUKEE, WI 53215-2527
(414) 383-3414
(414) 383-3588
Mailing address
2410 W FOREST HOME AVE, MILWAUKEE, WI 53215-2527
(414) 383-3414
(414) 383-3588
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
14486040
WI
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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