Individual
DR. JUSTIN R SUPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Contact information
Practice address
21431 GRAND RIVER AVE, DETROIT, MI 48219-3801
(313) 778-7610
(313) 778-7665
Mailing address
5580 LARKINS DR, TROY, MI 48085
(131) 778-7610
(313) 778-7665
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302041356
MI
Other
Enumeration date
09/14/2016
Last updated
09/14/2016
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