Individual
LISA DIEPHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
115 E MAIN AVE, ZEELAND, MI 49464-1735
(616) 772-4685
Mailing address
115 E MAIN AVE, ZEELAND, MI 49464-1793
(616) 772-4685
(616) 772-9526
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302041348
MI
Other
Enumeration date
06/23/2017
Last updated
09/26/2022
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