Individual
JEFFREY JOHN WIECZOREK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
B.S.
Contact information
Practice address
9416 WILDWOOD LAKE DR, WHITMORE LAKE, MI 48189-9430
(734) 449-8706
(734) 449-8706
Mailing address
9416 WILDWOOD LAKE DR, WHITMORE LAKE, MI 48189-9430
(734) 449-8706
(734) 449-8706
Taxonomy
Speciality
Code
Description
License number
State
1835P1200X
Pharmacotherapy Pharmacist
Primary
5302032120
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5302032120
—
MI
Enumeration date
06/03/2014
Last updated
06/23/2014
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