Individual
ALISON LOUISE MOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
520 PALOMINO AVE, PORTAGE, MI 49002-6025
(269) 501-3823
Mailing address
6839 S WESTNEDGE AVE, PORTAGE, MI 49002-3582
(269) 327-9646
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302031737
MI
Other
Enumeration date
06/09/2023
Last updated
06/09/2023
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