Individual
ALEXANDER JAMES GROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 W NORTH ST, STE 104, JACKSON, MI 49202-3196
(248) 647-9790
Mailing address
328 S HOUGHTON ST, MILFORD, MI 48381-2414
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901005121
MI
Other
Enumeration date
06/13/2018
Last updated
08/07/2019
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