Individual
DR. JAY ERIC LASSILA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
236 HEMLOCK ST, KINGSFORD, MI 49802-5304
(906) 370-9750
Mailing address
236 HEMLOCK ST, KINGSFORD, MI 49802-5304
(906) 370-9750
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302035380
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302035380
PHARMACY LICENSE
MI
Enumeration date
04/01/2010
Last updated
04/01/2010
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