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Individual

JOEL GROMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
415 N 9TH ST, STE 6W100, SPRINGFIELD, IL 62702-5303
(217) 545-5117
(217) 545-4912
Mailing address
PO BOX 19640, SPRINGFIELD, IL 62794-9640
(217) 545-5117
(217) 545-4912

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Enumeration date
05/04/2009
Last updated
11/09/2010
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