Individual
KEITH ALLAN MISIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2236 US HIGHWAY 23 S, ALPENA, MI 49707-4544
Mailing address
2236 US HIGHWAY 23 S, ALPENA, MI 49707-4544
(989) 354-2171
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302028446
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336199025
—
MI
Enumeration date
06/18/2018
Last updated
06/18/2018
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