Individual
LAUREN TACKEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
8641 N TELEGRAPH RD, DEARBORN HEIGHTS, MI 48127-1425
(313) 277-0098
(313) 277-0208
Mailing address
5721 REVETON RD, WEST BLOOMFIELD, MI 48322-1355
(313) 277-0098
(313) 277-0208
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302022478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302022478
PHARMACIST LICENSE NUMBER
MI
Enumeration date
10/10/2006
Last updated
07/08/2007
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