Individual
DONNA FOPMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5575 BYRON CENTER AVE SW, WYOMING, MI 49519-9603
(616) 534-5175
(616) 534-5452
Mailing address
5575 BYRON CENTER AVE SW, WYOMING, MI 49519-9603
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302025956
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5302025956
PHARMACIST LICENSE
MI
Enumeration date
10/10/2011
Last updated
10/10/2011
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