Individual
ANITHA DASARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
61019 SILVER LAKE RD, SOUTH LYON, MI 48178-9209
(248) 437-8626
Mailing address
61019 SILVER LAKE RD, SOUTH LYON, MI 48178-9209
(248) 437-8626
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302045359
MI
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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