Individual
SHANE BENTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
4562 W HOUGHTON LAKE DR, HOUGHTON LAKE, MI 48629-9005
(989) 366-9212
(989) 366-4776
Mailing address
4562 W HOUGHTON LAKE DR, HOUGHTON LAKE, MI 48629-9005
(989) 366-9212
(989) 366-4776
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
5303022152
MI
Other
Enumeration date
08/03/2021
Last updated
08/03/2021
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