Most Relevant Information
Provider Data
| NPI Number: | 1003404682 |
| Provider Name: | MITCHELL GROTH PHARMD |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 19925 |
Most Important Dates
| Enumeration Date: | 01/08/2021 |
| Last Updated: | 01/08/2021 |
Provider Practice Location
N85W15882 APPLETON AVE
MENOMONEE FALLS
WI
530513082
Practice Location Phone/Fax
| Phone: | 2624370031 |
| Fax: |
Provider Mailing Location
161 N STORY PKWY
MILWAUKEE
WI
532083618
Provider Mailing Phone/Fax
| Phone: | 2625017371 |
| Fax: |