Individual
CHARLES STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1997 E BELTLINE AVE NE, GRAND RAPIDS, MI 49525-4545
(616) 447-1510
Mailing address
735 BRISTOL AVE NW, GRAND RAPIDS, MI 49504-4837
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302038934
MI
Other
Enumeration date
02/05/2017
Last updated
02/05/2017
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