Individual
JACLYN MARIE CARNAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8531 E LANSING RD, DURAND, MI 48429-1072
(989) 288-3101
(989) 288-0017
Mailing address
9671 HENDERSON RD, CORUNNA, MI 48817-9793
(989) 413-3886
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303009757
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5303009757
LARA
MI
Enumeration date
03/16/2022
Last updated
03/16/2022
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