Individual
LANCE AZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
41460 HAGGERTY CIR S, CANTON, MI 48188-2227
(888) 282-5166
Mailing address
41460 HAGGERTY CIR S, CANTON, MI 48188-2227
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302040265
MI
Other
Enumeration date
12/01/2017
Last updated
12/01/2017
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