Individual
MICHELLE BURLESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15445 AL HIGHWAY 24, MOULTON, AL 35650-6602
(256) 974-1597
Mailing address
2454 COUNTY ROAD 1162, CULLMAN, AL 35057-0641
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20633
AL
Other
Enumeration date
10/10/2018
Last updated
10/10/2018
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