Individual
MRS. MICHELLE ANN ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9267 PAULINE ST, MONTAGUE, MI 49437-1021
(231) 709-8147
Mailing address
9267 PAULINE ST, MONTAGUE, MI 49437-1021
(231) 709-8147
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303002404
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5303002404
PHARMACY TECH LIMITED LICENSE
MI
Enumeration date
08/25/2015
Last updated
08/25/2015
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