Individual
ETHAN PENNYWITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
419 W MAIN ST, GAYLORD, MI 49735-1859
(989) 732-5220
Mailing address
800 SILVER PINE CIR APT 30, GAYLORD, MI 49735-9804
(419) 973-5720
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302414620
MI
Other
Enumeration date
08/30/2022
Last updated
08/30/2022
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