Individual
MRS. BONITA SIMCHA BOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R PH
Contact information
Practice address
21298 MELROSE AVENUE, SOUTHFIELD, MI 48075-7901
(248) 827-3370
(248) 827-3375
Mailing address
205 LAKE PARK DRIVE, BIRMINGHAM, MI 48009-4605
(248) 645-0375
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025029
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302025029
PHARMACY LICENSE
MI
Enumeration date
11/16/2006
Last updated
07/08/2007
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