Individual
EILEEN MIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 US 31 S, TRAVERSE CITY, MI 49684-4520
(231) 995-0207
Mailing address
2401 US 31 S, TRAVERSE CITY, MI 49684-4520
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028518
MI
Other
Enumeration date
12/17/2015
Last updated
12/17/2015
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