Individual
MICHELLE EDMUNDS BRASWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4119 W MAIN ST, DOTHAN, AL 36305-1023
(334) 793-1316
(334) 793-4920
Mailing address
900 WATERFORD WAY, ASHFORD, AL 36312-5492
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
12727
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12727
AL BOARD OF PHARMACY LIC
AL
Enumeration date
05/21/2007
Last updated
07/08/2007
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