Individual
LESHIA RENE MARTINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 WEST RD, TRENTON, MI 48183-2676
(734) 675-2997
(734) 675-6695
Mailing address
15035 WILLIAMSBURG ST, RIVERVIEW, MI 48193-7703
(734) 285-2415
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302410542
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302410543
PHARMACIST LICENSE
MI
Enumeration date
09/15/2011
Last updated
09/15/2011
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