Individual
MR. LARRY C DITTMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 S LAKE ST, EAST JORDAN, MI 49727-9376
(231) 536-0901
Mailing address
112 W CAYUGA ST, P.0.BOX 352, BELLAIRE, MI 49615-8101
(231) 533-8729
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302023411
MI
Other
Enumeration date
09/13/2006
Last updated
07/08/2007
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