Individual
MRS. BONITA JACQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1250 PERRY AVE, BIG RAPIDS, MI 49307-2115
(231) 796-5252
Mailing address
13377 WOODLAND CT, BIG RAPIDS, MI 49307-9448
(231) 796-3871
(231) 796-3879
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302023883
MI
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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