Individual
JOHN GROGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3176 ABBOTT RD STE 800, ORCHARD PARK, NY 14127-1069
(716) 391-5707
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
372600000X
Adult Companion
—
—
Other
Enumeration date
11/12/2007
Last updated
02/22/2022
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