Individual
BHOOMI SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
22318 PONTIAC TRAIL, SOUTH LYON, MI 48178
(248) 486-5216
Mailing address
22318 PONTIAC TRAIL, SOUTH LYON, MI 48178
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302045146
MI
Other
Enumeration date
06/27/2020
Last updated
06/27/2020
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