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Individual

TENNILLE JUDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5150 COOLIDGE HWY, ROYAL OAK, MI 48073-1001
(248) 280-5033
Mailing address
2041 KIRKTON DR, TROY, MI 48083-1624
(248) 703-5795

Taxonomy

Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302033627
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5302033627
PHARMACIST LICENSE #
MI
Enumeration date
05/01/2014
Last updated
05/01/2014
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