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Individual
MR. SHAWN M FREESE
Active
Individual
MR. SHAWN M FREESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028811
MI
2255A2300X
Athletic Trainer
5302028811
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PHARMACY LICENSE
5302028811
MI
Enumeration date
03/27/2007
Last updated
12/06/2019
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