Individual
MRS. DEB GUSTAFSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
961 SPRING ST, MUSKEGON, MI 49442-3278
(231) 722-2861
Mailing address
19045 WALDEN DR, SPRING LAKE, MI 49456-1172
(616) 842-7614
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302024218
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302024218
RPH LICENSE
MI
Enumeration date
10/11/2006
Last updated
07/08/2007
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