Individual
JEANINE L. GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
6777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-3013
(248) 661-6488
(248) 661-6489
Mailing address
29835 NORTHBROOK ST, FARMINGTON HILLS, MI 48334-2326
(248) 851-9320
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302021043
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302021043
PERMANENT ID NUMBER
MI
Enumeration date
10/23/2006
Last updated
07/08/2007
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